Quick Summary
Pineapple (Ananas comosus) contains bromelain, a proteolytic enzyme complex studied for its anti-inflammatory, antimicrobial, and wound healing properties. Clinical evidence on pineapple or bromelain supplementation suggests some potential benefits in reducing inflammation, supporting recovery after surgery, improving wound healing, and modulating certain disease-related parameters such as lipid profiles and diabetic macular edema. However, most evidence comes from small clinical trials or in vitro studies, so definitive conclusions are premature.
What is it
Pineapple is a tropical fruit native to South America, well-known for its sweet flavor and nutritional content. It contains bromelain, a mixture of proteolytic enzymes primarily derived from the stem and fruit, which has attracted scientific interest for potential therapeutic effects.
Traditional Uses
Traditionally, pineapple and its extracts have been used in folk medicine to support digestion, reduce swelling, improve wound healing, and treat infections. It is also consumed as a food and natural remedy for various inflammatory conditions.
Active Compounds
- Bromelain: A proteolytic enzyme complex with potential anti-inflammatory, antimicrobial, and fibrinolytic properties.
- Other compounds may include vitamins, minerals, and flavonoids present in the fruit, though bromelain is the primary focus of research.
Potential Benefits with Evidence Levels
- Anti-inflammatory effects (Limited clinical evidence): A systematic review of 7 randomized controlled trials indicated bromelain supplementation reduced certain inflammatory markers in adults, although results varied due to population, dosage, and intervention differences.
- Support of postoperative recovery (Pilot clinical study): In older adults following hip or knee arthroplasty, a supplement containing bromelain combined with troxerutin and escin was linked to reduced postoperative pain and edema as well as improved functional recovery compared to controls.
- Improvement of oral health (Randomized controlled trial): A dentifrice containing bromelain, papain, miswak, and neem showed significant reduction in dental plaque and improved gingival health in orthodontic patients versus standard toothpaste.
- Antimicrobial activity (One RCT plus in vitro studies): Bromelain extract demonstrated effectiveness against Enterococcus faecalis in infected root canals, suggesting potential use in root canal treatments.
- Support in diabetic macular edema (Small clinical trial): Oral supplementation with bromelain and diosmin showed statistically significant improvement in central retinal thickness in diabetic patients receiving anti-VEGF therapy.
- Improved lipid profiles in type 2 diabetes (Observational study): Use of herbal medicines including pineapple-based products was associated with better serum lipid profiles in type 2 diabetic patients, though causality cannot be confirmed.
Side Effects
Bromelain supplementation was generally well tolerated in clinical studies. The most commonly reported adverse effects were mild gastrointestinal symptoms such as upset stomach. No serious adverse events were directly attributed to pineapple or bromelain. In animal studies, rare gastrointestinal upset was noted with bromelain-containing products.
Drug Interactions
No specific clinical evidence of drug interactions with pineapple or bromelain was identified. However, due to bromelain’s proteolytic enzyme activity, there is a theoretical potential for interactions with anticoagulants or drugs metabolized by proteolytic pathways. Further research is needed to clarify interaction risks.
Who Should Avoid It
No specific contraindications have been identified in clinical evidence. Caution is advised for pregnant or breastfeeding women due to lack of safety data. Individuals with known allergies to pineapple or bromelain should avoid use.
Evidence Limitations
The available clinical evidence is limited by small sample sizes, heterogeneity in bromelain dosages and formulations, combination with other substances, short intervention durations, and varied study populations. Many reported benefits are based on pilot or observational studies and in vitro research. Larger, well-designed randomized controlled trials are necessary to confirm efficacy and safety.
References
- Pereira IC et al. (2023). Bromelain supplementation and inflammatory markers: A systematic review of clinical trials. doi:10.1016/j.clnesp.2023.02.028
- Landi F et al. (2025). Supplementation with Bromelain, Troxerutin, and Escin to Support Postoperative Recovery After Hip or Knee Arthroplasty in Older Adults: A Pilot Study. doi:10.3390/nu17243815
- Tadikonda A et al. (2017). Anti-plaque and anti-gingivitis effect of Papain, Bromelain, Miswak and Neem containing dentifrice: A randomized controlled trial. doi:10.4317/jced.53593
- Chandwani ND et al. (2025). Antimicrobial efficacy of pineapple extract Bromelain against Enterococcus faecalis in infected root canals: A systematic review. doi:10.4103/jcde.jcde_400_25
- Vingolo EM et al. (2025). Diabetic Macular Edema in Maintenance Intravitreal Scheduling. doi:10.3390/pharmaceutics17050605
- Asrie AB et al. (2026). Impacts of Herbal Medicine Use on Lipid Profiles in Type 2 Diabetic Patients in Northwest Ethiopia: A Comparative Cross-Sectional Study. doi:10.1155/bmri/1020727
- Shoham Y et al. (2023). Bromelain-based enzymatic burn debridement: A systematic review of clinical studies on patient safety, efficacy and long-term outcomes. doi:10.1111/iwj.14308
Last Reviewed
April 2024
Disclaimer: This page is for informational purposes only and does not provide medical advice. Always consult a healthcare professional before using herbal supplements, especially if you have underlying health conditions or are taking medications.