Common Names: bromelain, pineapple enzyme

Scientific Name: Ananas comosus (pineapple plant)

Background

• Bromelain refers to a mix of protein-digesting enzymes mainly sourced from the stem and fruit of pineapple.

• Pineapples have a long history of medicinal use in parts of Central and South America.

• Today, bromelain is a popular supplement believed to support recovery from surgery, manage sinus inflammation, ease joint discomfort from arthritis, and lessen muscle soreness after intense activity. It’s also been approved for prescription use on the skin in managing burns.

How Much Do We Know?

• Limited research has been conducted on bromelain taken orally, particularly for sinus issues and pain after removal of wisdom teeth. Studies on other uses tend to involve products combining bromelain with additional substances, making it difficult to isolate bromelain’s effects.

• In 2022, the FDA authorized a bromelain-based topical drug for cleaning dead tissue in patients with severe burns. A similar product received approval in the European Union as well.

What Have We Learned?

• There isn’t enough reliable evidence to confirm that bromelain on its own can effectively treat sinus inflammation.

• Some clinical trials indicate bromelain may ease pain and swelling commonly experienced after surgical removal of wisdom teeth.

• Bromelain applied to the skin has been used successfully by healthcare professionals as a non-surgical method for burn wound cleaning.

What Do We Know About Safety?

• Taking bromelain by mouth is generally well tolerated. Some users have reported mild side effects like digestive upset or diarrhea.

• If you are on medication, it's important to consult your healthcare provider before using bromelain, as it might interact with certain drugs.

• Information is lacking regarding the safety of bromelain during pregnancy or while breastfeeding.

Keep in Mind

• It’s important to keep your healthcare providers informed about all the health approaches you're using. Working together can help you make well-considered, informed decisions.

• Herbal products come under different regulations based on their formulation and how they're intended for use. Most products taken by mouth are considered dietary supplements, which are regulated differently than medications.

• Unlike prescriptions, dietary supplements are not reviewed or approved by the FDA before they're released to the market. However, if safety concerns arise, the FDA has the authority to act. Manufacturers are ultimately responsible for ensuring their products are safe and appropriately labeled before being sold.

Key References

• Bromelain. NatMed Pro database. Accessed September 19, 2023.

• Chakraborty AJ, Mitra S, Tallei TE, et al. An extensive review of bromelain as a beneficial compound in pharmacology. Life (Basel). 2021;11(4):317.

• Griffin AS, Cabot P, Wallwork B, et al. Overview of alternative options for chronic rhinosinusitis. Ear, Nose & Throat J. 2018;97(3):E25-E33.

• Gupta AA, Kambala R, Bhola N, et al. Comparison of bromelain and aceclofenac in reducing post-operative inflammation after molar removal. Journal of Dental Anesthesia and Pain Medicine. 2022;22(1):29-37.

• Leelakanok N, Petchsomrit A, Janurai T, et al. Bromelain’s effectiveness and safety: findings from a systematic review. Nutrition and Health. 2023;29(3):479-503.

• Liu S, Zhao H, Wang Y, et al. Analysis of bromelain’s role in managing facial swelling and pain after molar extraction. Journal of Oral and Maxillofacial Surgery. 2019;77(8):1566-1574.

• Mendes M-L-T, do Nascimento-Júnior E-M, Reinheimer D-M, et al. Review of bromelain’s benefits following third molar surgery. Medicina oral, patologia oral y cirugia bucal. 2019;24(1):e61-e69.

• Shoham Y, Gasteratos K, Singer AJ, et al. Review of bromelain-based treatments for burn care, including effectiveness and outcomes. International Wound Journal. 2023;20(10):4364-4383.

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This content is provided by the National Center for Complementary and Integrative Health and is offered for informational purposes only. It should not replace personalized advice or care from your medical professionals. The inclusion of any treatment or product does not imply endorsement.