Proteolytic Enzymes

Supplement Forms/Alternate Names:

Bromelain, chymotrypsin, digestive enzymes, pancreatin, papain, serrapeptase, trypsin

Introduction

Proteolytic enzymes are a group of compounds that help the body break down food. They have been used to ease digestion. They have also been used to ease pain and promote healing in skin, muscle, and joint problems. Proteolytic enzymes can be taken as a pill. Some can also be applied to the skin or inhaled.

Dosages

There are no advised doses for proteolytic enzymes.

What Research Shows

Likely Effective

  • Third molar surgery —bromelain likely to ease pain, swelling, and improve quality of life after surgery C1,C2

May Be Effective

  • Wounds —trypsin may ease pain and quicken healing D1

May Not Be Effective

  • Post-procedure ecchymosis or edema —bromelain may not have benefit B1

Unlikely to Be Effective

  • Chronic pancreatitis —pancreatin is unlikely to ease abdominal pain A1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It is likely safe to take proteolytic enzymes in small doses for a short time, but tummy upset and allergic reactions may happen. Not enough studies have been done to say whether they are safe to take for a long period. It is also not known whether it is safe to take by women who are pregnant or breastfeeding. Papain should not be taken by mouth during pregnancy.

Interactions

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.

References

A. Chronic Pancreatitis

A1. Yaghoobi M, McNabb-Baltar J, et al. Pancreatic Enzyme Supplements Are Not Effective for Relieving Abdominal Pain in Patients with Chronic Pancreatitis: Meta-Analysis and Systematic Review of Randomized Controlled Trials. Can J Gastroenterol Hepatol. 2016;2016:8541839.

B. Post-Procedure Ecchymosis or Edema

B1. Ho D, Jagdeo J, et al. Is There a Role for Arnica and Bromelain in Prevention of Post-Procedure Ecchymosis or Edema? A Systematic Review of the Literature. Dermatol Surg. 2016 Apr;42(4):445-463.

C. Third Molar Surgery

C1. Mendes ML, do Nascimento-Júnior EM, et al. Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e61-e69.

C2. de Souza GM, Fernandes IA, et al. Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis. Phytother Res. 2019 Mar;33(3):473-481.

D. Wounds

D1. Chandanwale A, Langade D, et al. A Randomized, Clinical Trial to Evaluate Efficacy and Tolerability of Trypsin:Chymotrypsin as Compared to Serratiopeptidase and Trypsin:Bromelain:Rutoside in Wound Management. Adv Ther. 2017;34(1):180-198.

Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 4/17/2020

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