Nature's Ibuprofen: Pineapple Pill Beats Big Pharma for Pain

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A new study found that the pineapple enzyme bromelain reduces pain as effectively as the popular drug ibuprofen after dental surgery

Recent research investigated whether bromelain, an enzyme derived from pineapple stems, could match ibuprofen in relieving pain after periodontal (gum) procedures. Periodontal surgeries like crown lengthening can damage tissues, triggering inflammation and pain. Drugs like ibuprofen block messenger chemicals called prostaglandins to reduce swelling and discomfort. But these non-steroidal anti-inflammatory drugs (NSAIDs) also raise gastrointestinal and cardiovascular risks. The study tested whether a natural pineapple extract could provide similar benefits with fewer side effects.  

In the randomized, double-blind trial, 22 dental patients undergoing crown lengthening on two sides of the upper jaw received either bromelain (500 gelatin digestive units) or ibuprofen (400 milligrams) immediately after surgery and 6 hours later. The doses were packaged identically so neither researchers nor subjects knew who received which pill ("blinding"). Using self-reported pain scales, discomfort levels were tracked for 48 hours post-operation. Ibuprofen performed significantly better only at the 4-hour mark. For all other measurements (2 hours and 6-48 hours later), bromelain relieved pain and inflammation as effectively as the standard NSAID.

Bromelain contains a mixture of protein-digesting enzymes with anti-inflammatory, antithrombotic, and fibrinolytic (clot-busting) effects. Studies suggest it reduces swelling and pain by increasing blood flow, inhibiting production of inflammatory prostaglandins, removing fibrin clots and debris, and suppressing bradykinin--a peptide that stimulates pain nerves. The dose and timing protocols used here appeared sufficient to match ibuprofen, the most widely used dental pain medication. Though more research is needed, these initial results suggest pineapple-stem enzymes could provide an effective, lower-risk alternative to NSAID pain relievers.

The study has limitations, including its small sample size. However, by demonstrating the promise of natural agents like bromelain, the findings could help reduce over-reliance on pharmaceuticals--including addictive opioid painkillers--for post-surgical recovery. Further research should investigate optimal bromelain doses for pain relief and wound healing. Standardized enzyme preparations may also enhance consistency versus raw pineapple juice

An Important Note on the Perils of Ibuprofen While effective for dental pain, ibuprofen has significant adverse effects, especially with chronic use. Ibuprofen and related NSAIDs are associated with increased risk of gastrointestinal bleeding and ulcers, kidney toxicity, and cardiovascular events like heart attack and stroke.1 In one recent analysis, regular NSAID consumption doubled cardiovascular risk after only several weeks.2 Ibuprofen’s blood-thinning properties can also promote hemorrhage after surgery.

In contrast, bromelain appears safer with prolonged intake. In human trials, side effects were generally mild, like gastrointestinal discomfort.3 Bromelain also showed versatile health benefits beyond pain and inflammation. Research indicates bromelain supports cardiovascular, respiratory, digestive, immune, and musculoskeletal function, among other areas.4 It may even have anti-tumor effects.5 With wide-ranging therapeutic actions but limited risks, pineapple-stem enzymes could provide a safer alternative for managing post-operative and chronic pain.

To learn more about other evidence-based natural alternatives to ibuprofen, read our article on the topic here: 6 Natural Ibuprofen Alternatives Backed by Clinical Research.

Learn more about the therapeutic potential of bromelian here.


1. Wallace JL. Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy. World J Gastroenterol. 2013;19(12):1861-76.

2. Bally M, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ. 2017;357:j1909.

3. Walker AF, et al. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine. 2002;9(8):681-6.

4. Pavan R, et al. Properties and therapeutic application of bromelain: A review. Biotechnol Res Int. 2012;2012:976203.

5. Chobotova K, et al. Bromelain’s anti-cancer potential: A review. Cancer Lett. 2010;290(2):148-56.

6. Bromelain. Accessed [Feb 12, 2024].

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