Written by Tatjana Djakovic, Staff Writer. In a study of 77 subjects given 200 mg or 400 mg bromelain daily, those in the higher group had a 18% greater pain reduction and 2.5% less anxiety and 3.1% less depression.
Supplemental digestive enzymes are used to relieve the symptoms associated from gastrointestinal disorders as well as to support overall health and well being. Digestive enzymes come from a variety of sources, including animals, microorganisms, and plants. Some enzymes are extracted or synthesized and have been used in the management of enzyme deficiencies (1).
Some digestive enzymes are derived from plant sources like pineapple and papaya. Bromelain is a naturally occurring enzyme found in the pineapple fruit and stem (2), while papain is found in the papaya fruit (3). One study found that a combination of enzymes, ox bile, pancreatin and bromelain lowered stool fat excretion in some patients with pancreatic steatorrhea resulting in relief from pain, excess flatulence and diarrhea (4).
In addition to serving as an enzyme that breaks down protein in the body, bromelain also supports the overall health of the body. Clinical studies have shown that bromelain can reduce symptoms of arthritis by serving as an anti-inflammatory without serious side effects of gastrointestinal problems. A clinical study investigated the effects of bromelain on mild acute knee pain in otherwise healthy adults as well as general well being (5). The study consisted of 77 subjects; 43 had taken the lower dose of 200mg bromelain daily and 34 the higher dose of 400 mg of bromelain daily. In order to assess knee pain, the participants filled out a questionnaire consisting of 24 question such as pain, stiffness and physical function on a scale of 0 (no pain) to 10 (extreme pain). The overall health was assessed using a psychological index consisting of 22 questions scored on scale of 0 (the most negative response) to 5 (the most positive response) relating to anxiety, depressed mood, positive well being, self-control, general heath and vitality.
In both treatment groups, all symptom scores were significantly reduced compared to baseline, with reduction of total symptom score of 41 % in the group that took lower dose of 200 mg of bromelain (p<0.001), and a reduction of 59 % in the group that took the higher dose of 400 mg. Similarly, pain decreased by 44.6 % in lower dose group and by 58.2 % in the higher dose group; and stiffness decreased by 44.6 % in lower dose group and 65.7 % in higher dose group (p<0.0001).
Anxiety scores improved by 6.8 % in lower dose group and 8.9 % in higher dose group, and depression improved by 3.2 % in lower dose group and by 6.34 % in higher dose group (p<0.03). General health of the subjects improved by 8.8 % in lower dose group and 15.1 % in higher dose group (p<0.001). A post-study questionnaire indicated that 59.5 % of participants in lower dose group and 67.6 % in high dose group reported a definite overall improvement in knee pain. For future purposes, it would be beneficial to include a double-blind placebo controlled trial to validate these results (5).
Source: Walker, A. F., et al. “Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.” Phytomedicine 9.8 (2002): 681-686.
Copyright © 2002 Urban & Fischer Verlag. Published by Elsevier GmbH All rights reserved.
Posted February 13, 2013.
References:
- Roxas, Mario. “The role of enzyme supplementation in digestive disorders.” Altern Med Rev 13.4 (2008): 307-14.
- Hale, Laura P., et al. “Dietary supplementation with fresh pineapple juice decreases inflammation and colonic neoplasia in IL‐10‐deficient mice with colitis.” Inflammatory bowel diseases 16.12 (2010): 2012-2021.
- Pendzhiev, A. M. “Proteolytic enzymes of papaya: medicinal applications.” Pharmaceutical Chemistry Journal 36.6 (2002): 315-317.
- Balakrishnan V, Hareendran A, Nair CS. Double-blind cross-over trial of an enzyme preparation in pancreatic steatorrhea. J Assoc Physicians India. 1981(29): 207-209.
- Walker, A. F., et al. “Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.” Phytomedicine 9.8 (2002): 681-686.
