The role of bromelain in alternative medicine is certainly intriguing, but it requires larger, better-controlled human clinical trials. Similar to many botanicals, the appeal of “natural” may seem alluring to some. However, the potential for side effects is the same as for a patented medication, and botanicals are not as well-studied. 

As a treatment for serious burns, the use of bromelain-containing products should be considered when used as an aid in the process of debridement. Otherwise, perhaps the pineapple should remain in the Hawaiian drinks with the umbrella. 

Sherril Sego, FNP-C, DNP, is an independent consultant in Kansas City, Mo. 


  1. National Institutes of Health National Center for Complementary and Integrative Health. Bromelain. August 2014. 

  2. Rosenberg L, Lapid O, Bogdanov-Berezovsky A, et al. Safety and efficacy of a proteolytic enzyme for enzymatic 
burn debridement: a preliminary report. Burns. 2004;30(8):843-850.

  3. Akhtar NM, Naseer R, Farooqi AZ, et al. 
Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee—a double-blind prospective randomized study. Clin Rheumatol. 2004;23(5):410-415.

  4. Kleef R, Delohery TM, Bovbjerg DH. Selective modulation of cell adhesion molecules on lymphocytes by bromelain protease 5. Pathobiology. 1996;64(6):339-346. 

  5. Müller S, März R, Schmolz M, et al. Placebo-controlled randomized clinical trial on the immunomodulating activities of low- and high-dose bromelain after oral administration—new evidence on the anti-inflammatory mode of action of bromelain. Phytotherapy Res. 2013;27(2):199-204.

  6. Dawson J, Linsell L, Doll H. Assessment of the Lequesne index of severity for osteoarthritis of the hip in an elderly population. Osteoarthritis Cartilage. 2005;13(10):854-860.

  7. Báez R, Lopes MT, Salas CE, Hernández M. In vivo antitumoral activity of stem pineapple (Ananas comosus) bromelain. Planta Med. 2007;73(13):1377-1383. 

  8. Pavan R, Jain S, Singh S, Kumar A. Properties and therapeutic application of bromelain: a review. Biotech Res Int. 2012;2012:976203.

  9. Brien S, Lewith G, Walker A, et al. Bromelain as a treatment for osteoarthritis: a review of clinical studies. Evid Based Complement Alternat Med. 2004;1(3):251-257.

All electronic documents accessed May 5, 2016.

This article originally appeared on Clinical Advisor