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This article is from the WebMD News Archive
Supplement Use in Sickness and in Health
May 24, 2004 (New York) -- Bromelain found mostly in the stem of pineapples, may help reduce some of the complications of surgery, according to new research. But other common supplements may pose risks to surgical patients and need to be discontinued before undergoing cosmetic or other surgeries.
"Bromelain is an anti-inflammatory [that] prevents soft tissue swelling, and decreases various markers of pain and inflammation," says wellness expert David H. Rahm, MD, president of VitaMedica Corporation in Manhattan Beach, Calif. "It also enhances the effectiveness of antibiotics," he adds.
He presented his findings at a meeting on rejuvenation medicine, jointly sponsored by the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons in New York City.
In one study of 74 boxers, 80% of minor injuries from bruising and swelling cleared in just four days in those boxers who took bromelain supplements after a big fight, compared with only 14% clearing of minor injuries in those who took placebo.
In one study involving people ready to undergo surgery, those who took bromelain supplement 48 to 72 hours before surgery healed quicker than those who took it just one hour before surgery.
"Bromelain is best administered 72 hours prior to surgery, taken three to four times a day in doses of about 2,000 to 3,000 milk-clotting units a day," Rahm says.
But bromelain is not for everyone including children, anyone with allergies to pineapple or bee stings as well as anyone with a history of heart palpitations, he cautions. Bromelain also acts like a blood thinner; anyone taking blood thinners should avoid taking this supplement.
Don't Ask, Don't Tell Can Be Dangerous
Herein lies the problem. According to Rahm, 51% of surgical patients take supplements before surgery and 70% do not report this to their surgeons. This practice can have deleterious effects on the outcome as some supplements increase risk of prolonged bleeding, decrease or increase the effects of anesthesia, cause heart disturbances, and/or interact with other medications.
For example, many supplements need to be discontinued around the time of surgery including the five most popular supplements: echinacea, St. John's wort, garlic, ginkgo, and ginseng.
"If we can control the supplements that patients are taking before surgery, we can mitigate the complications," he says. "I think that patients, as always, should look to their doctors for information [and] if the surgeon hasn't asked about the nutritional supplements that you are taking and hasn't given advice on which to discontinue prior to surgery, then the patients should ask the surgeon about it," he tells WebMD.
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