How does bromelain help wound healing? Bromelain helps with wound healing by 1) reducing existing tissue swelling through the enzymatic breakdown of blood clots, resulting in increased tissue permeability and reabsorption of edema fluid into blood circulation 2) improving the tissue permeability of antibiotic drugs and resulting in higher antibiotic levels 3) stimulation of white blood cells to kill bacteria 4) increasing anti- inflammatory mediators 5) decreasing pain and 6) decreasing healing time. [12, 14] Studies in patients with acute sinusitis, face and head trauma, trauma of the lower extremity, childbirth, and oral surgery support these findings. For example, in dental surgery patients, bromelain was found to decrease swelling in the early and late stages after surgery. In addition, pain was reduced in the treatment group, likely by decreasing mediators of pain. [15] Based on the available evidence, bromelain was approved in Germany for acute post-operative (ENT surgeries) and post-traumatic conditions of swelling. [16] How does bromelain help pain? Bromelain has both a direct influence on pain by decreasing pain mediators such as bradykinin, as well as indirect effects through its anti-inflammatory actions (e.g. reduction in edema, debris and immune complexes). [17] Bromelain was first reported to be of value as an analgesic/anti-inflammatory for use in rheumatoid arthritis and osteoarthritic patients in 1964. Subsequent studies have continued to support the use of bromelain to manage pain in patients with osteoarthritis. [18] Bromelain also appears to be effective in reducing swelling, bruising, and pain in women having episiotomy (a surgical cut made at the opening of the vagina during childbirth). [19]
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