Bromelain, a mixture of proteases extracted from the stem of the pineapple, has been used by Europeans for many years to inhibit inflammatory factors. Bromelain's fluid-regulating properties may result from its ability to effectively inhibit inflammatory cytokine production, inhibit neutrophil migration, and support removal of some cell surface inflammatory molecules. Research also shows that bromelain may help support healthy blood viscosity and blood platelet aggregation.

Bromelain has to be enteric coated so that it will not be activated in the stomach and used as a digestive enzyme. Enteric-coated bromelain tablets pass into the small intestine where they are absorbed into the bloodstream to provide systemic benefits.

Specially coated bromelain may significantly modulate inflammatory reactions in the joints. Research has demonstrated that enteric-coated bromelain formulations are at least as effective as other approaches in supporting joint comfort, function and health and are well tolerated. One study even found that bromelain is more effective than other methods for maintaining joint function at rest (41% for bromelain versus 23% for other methods).

Another study showed that specially coated bromelain yielded an overall improvement in general well-being, along with improvement in comfort and physical function.