Skip to content

Coming soon. The store is not open yet.

Menu
Full Measure

Safety

Do digestive enzymes cause diarrhea?

Written by the Full Measure editorial team, which sells supplements. Approved for publication by the Full Measure owners. Updated .

Drafted with AI assistance from the sources listed below. How we write these

Quick answer

They can for some people. NCCIH says stomach upset and diarrhea are the side effects most often reported with oral bromelain, and a review of 54 articles listed flatulence, nausea and headache. The prescription pancrelipase label lists abdominal pain, diarrhea, flatulence, constipation and nausea. Ask your doctor about diarrhea that lasts or comes with other symptoms.1,2,3

Key facts

  • NCCIH says stomach upset and diarrhea are the side effects most often reported with oral bromelain, the pineapple enzyme.1
  • A 2023 systematic review of 54 articles on bromelain listed flatulence, nausea and headache as adverse events of oral use, and reported no major health risks.2
  • The label for prescription pancrelipase lists abdominal pain, diarrhea, flatulence, constipation and nausea among reactions reported after approval.3
  • MedlinePlus tells people taking pancrelipase to call a doctor right away about diarrhea, stomach pain or bloating, or trouble having bowel movements.4
  • LiverTox reports that bromelain has not been linked to raised liver enzymes or to liver injury.5

What does NCCIH say about bromelain side effects?

Stomach upset and diarrhea are the side effects most often reported with oral bromelain.1

NCCIH adds that bromelain seems to be well tolerated when taken by mouth. That statement is about one enzyme from pineapple, and NCCIH's page does not rate the other enzymes in a typical blend, such as proteases made by molds, lipase or lactase.1

What do reviews and drug labels list?

A 2023 systematic review and meta-analysis of bromelain studies reported flatulence, nausea and headache as the adverse events of oral use, and no major health risks during treatment. It did not give rates for each effect in the abstract we read.2

The label for prescription pancrelipase lists, in the section for reactions identified after approval, abdominal pain, diarrhea, flatulence, constipation and nausea, and it notes that such reports come from a population of uncertain size, so frequency and cause cannot be worked out. In its clinical trials, vomiting, dizziness and cough were the most common adverse reactions in patients aged 7 and older, and vomiting, irritability and decreased appetite in younger children.3

MedlinePlus's page for the same medicine separates milder effects such as headache, gas and a feeling of fullness after a small meal from symptoms to report right away, which include diarrhea, stomach pain or bloating and difficulty having bowel movements.4

Can high amounts cause something worse?

The prescription pancrelipase label warns that very high doses, usually taken over long periods, have been linked to scarring and narrowing of the colon (fibrosing colonopathy), mostly in children with cystic fibrosis, and to raised uric acid.3

That warning concerns very high doses of a prescription medicine, mostly in children with cystic fibrosis, and the label caps the amount per kilogram of body weight for that reason. The sources do not say whether a supplement could reach those amounts, and they set no upper limit for supplements.3

Allergic reactions are rare but documented, both to bromelain and to lactase tablets made with Aspergillus, including one case of anaphylaxis after a single lactase tablet.6,7,8

Who should ask their doctor about diarrhea or stomach upset?

  • Anyone with diarrhea that lasts, or that comes with blood, fever, pain or weight loss, should ask their doctor, because these need a diagnosis.
  • Anyone who takes prescription pancreatic enzymes should ask their doctor before adding a supplement, because that medicine is started low and adjusted by a doctor for a diagnosed condition.4
  • Anyone with a past reaction to pineapple, papaya, latex or molds should ask their doctor, because allergic reactions to bromelain and to lactase tablets made with mold are rare but documented, and papaya can cross-react with latex.6,7,9

Avoid the combination unless your doctor advises it

The labels for acarbose and miglitol say that digestive enzyme products containing carbohydrate-splitting enzymes, such as amylase or pancreatin, may reduce the medicine's effect and should not be taken at the same time. Lactase and alpha-galactosidase also split carbohydrates. In a small trial, an alpha-galactosidase product taken with acarbose reduced gas but weakened the medicine's effect after meals.10,11,12,13

On the medicine's label

Questions people ask

Do digestive enzymes cause diarrhea?

They can. NCCIH says stomach upset and diarrhea are the side effects most often reported with oral bromelain. Ask your doctor if diarrhea lasts or comes with other symptoms.1

Do digestive enzymes cause gas or bloating?

A review of bromelain studies listed flatulence among the adverse events, and the pancrelipase label lists flatulence, while MedlinePlus lists bloating among symptoms to report right away for the medicine.2,3,4

Do digestive enzymes cause constipation?

The pancrelipase label lists constipation among reactions reported after approval, and MedlinePlus lists difficulty having bowel movements as a symptom to report. Neither is a statement about supplement blends.3,4

Do digestive enzymes cause headaches?

The bromelain review listed headache among adverse events, and MedlinePlus lists headache as a milder effect of pancrelipase.2,4

See what we make

Every product shows its whole label and what its lab report covers. The store opens soon.

See the Full Measure line

Sources

  1. National Center for Complementary and Integrative Health. Bromelain. Last updated November 2024. Opened 2026-10-07.
  2. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health. 2023;29(3):479-503. Opened 2026-10-11.
  3. Pancrelipase delayed-release capsules: prescribing information (AbbVie). DailyMed, U.S. National Library of Medicine. Published July 24, 2026. Opened 2026-10-07.
  4. MedlinePlus. Pancrelipase. U.S. National Library of Medicine. Last revised August 20, 2024. Opened 2026-10-07.
  5. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bromelain. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; updated February 10, 2024. Opened 2026-10-07.
  6. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy. 2001;56(3):257-258. Opened 2026-10-07.
  7. Voisin MR, Borici-Mazi R. Anaphylaxis to supplemental oral lactase enzyme. Allergy Asthma Clin Immunol. 2016;12:66. Opened 2026-10-07.
  8. Lohrenz SK, Kanani A. The cow's milk allergy that wasn't: allergy to supplemental oral lactase enzyme. Allergy Asthma Clin Immunol. 2023;19(1):61. Opened 2026-10-01.
  9. Drugs and Lactation Database (LactMed). Papaya. Bethesda (MD): National Institute of Child Health and Human Development; 2006 onward. Entry revised January 15, 2025. Opened 2026-10-11.
  10. Acarbose tablets: prescribing information (Strides Pharma Science Limited). DailyMed, U.S. National Library of Medicine. Published July 16, 2026. Opened 2026-10-07.
  11. Miglitol tablets: prescribing information (Westminster Pharmaceuticals). DailyMed, U.S. National Library of Medicine. Published December 8, 2021. Opened 2026-10-07.
  12. MedlinePlus. Acarbose. U.S. National Library of Medicine. Last revised December 15, 2017. Opened 2026-10-07.
  13. Lettieri JT, Dain B. Effects of beano on the tolerability and pharmacodynamics of acarbose. Clin Ther. 1998;20(3):497-504. Opened 2026-10-07.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.