Does papaya help with digestion and constipation?

We cannot say, because fresh papaya has never been tested for constipation in a controlled trial that we could find. The only randomized trial with constipation as an outcome used a fermented papaya preparation, 1.4 tbsp (20 ml) a day for 40 days, made with its papain activity raised 3.75-fold in processing. Constipation improved in 82% of the people analyzed on the product against 47% on placebo (p = 0.031), in just 17 and 19 people, and the benefit was gone after washout. Two meta-analyses of fruit for constipation, one of 11 trials and one of 23 studies in 1,714 adults, contain no papaya study at all.

Unsettled. The idea that papaya eases constipation is plausible and untested. The evidence that fruit helps comes mostly from kiwifruit and prunes. The one positive papaya result comes from a manufactured product with boosted enzyme activity, in a small subgroup, from a trial whose sponsorship is not disclosed in the text. None of that tells you what a slice of fresh papaya does.

What the trials found

The 2013 trial randomized 84 volunteers in Vienna with chronic indigestion and gut complaints, 42 to the fermented papaya preparation and 42 to placebo, double-blind, for 40 days. Symptoms were self-rated on a questionnaire. The constipation item was analyzed only in people who came back early, 17 on the product and 19 on placebo. In that group constipation improved in 82% against 47% (p = 0.031), and painful straining eased in 93% against 50% (p = 0.016). In the people assessed later, after a washout, no significant benefit remained. The full text says the researchers tried raw papaya puree in a pilot and dropped it in favor of the processed product. The authors are linked to the institute behind the preparation.

A second trial from the same group gave 60 people with mild chronic gastritis a papaya and oat preparation, 20 g twice a day for 30 days, on top of their usual treatment. Pain fell more than on placebo (p = 0.048), and both groups improved a lot. This trial was about stomach pain, not constipation, and the oats make it impossible to credit papaya.

The fruit meta-analyses explain why papaya keeps being mentioned without being tested. A 2022 review of 11 randomized trials found fruit raised stool frequency over placebo by a mean difference of 0.26 (95% CI 0.22 to 0.30), and most of that came from kiwifruit. A search of its full text found no papaya trial. A 2024 review of foods, drinks and diets for chronic constipation in adults gathered 23 studies (17 randomized) in 1,714 people. Its list covers kiwifruit, prunes, mango, fig, rye bread, oat bran and mineral water, and papaya is not on it. In that review fruit beat psyllium by 0.36 bowel movements a week (95% CI 0.25 to 0.48), in 232 people. If you want a fruit with trial evidence for constipation, that list is the place to start.

Who should be careful

Not for everyone. Papaya contains papain, a known allergen, and papain allergy can show up as gut symptoms. Of 500 allergy clinic patients skin-tested with papain, 5 had the allergy confirmed by a double-blind oral challenge, 1.05% of the allergic patients, with symptoms that included abdominal cramps and diarrhea. That study, from 1985, used papain itself and not fresh fruit.

People allergic to latex are the group most at risk. In a Spanish clinic study of 25 people with latex allergy, 13 (52%) also had food allergies, with 42 food reactions between them, 23 of them anaphylaxis, and papaya accounted for 3 cases. It is a small series. A Mexican series of 11 patients aged 7 to 46 with latex allergy and anaphylaxis after eating papaya traced the shared allergens to papain, chymopapain, caricaine and class I chitinases, and 63.6% of them were allergic to other foods too.

If you take warfarin, frequent use matters more than any single portion. Among 250 people in Hong Kong with atrial fibrillation on warfarin, 55% ate papaya. Those who ate more than one kind of herbal food at least 4 times a week spent less time in the target INR range, 51.1% against 58.1% (P = 0.046). Papaya was counted together with other herbal foods, and the study did not measure papaya on its own. We found only animal data on unripe papaya in pregnancy and did not use it.

What expert bodies say

We found no expert body that names papaya as a treatment for constipation. We looked for positions from the US National Institute of Diabetes and Digestive and Kidney Diseases, NICE and the European pediatric gastroenterology society, and none of them mentions it.

How we searched

What would change this answer

• A placebo-controlled randomized trial of fresh or dried papaya fruit, not an enzyme-boosted product, in adults with functional constipation, with stool frequency as the main outcome. We found no such trial registered.
• A head-to-head trial of papaya against kiwifruit or prunes, the fruits that already have trial evidence, which would show whether papaya belongs on the same list.
• Disclosure of who funded the 2013 trial, and a repeat of it by an independent group with all randomized participants analyzed.

More on papaya, including its carotenoids, glycemic index and food safety: papaya →

Sources

1. ev-pac-01 · Meta-analysis or systematic review · systematic review and meta-analysis · n = 23 studies (17 RCTs), 1714 participants
   We included 23 studies (17 RCTs, 6 uncontrolled; 1714 participants): kiwifruit (n = 7), high-mineral water (n = 4), prunes (n = 2), rye bread (n = 2), mango, fig, cereal, oat bran, yoghurt, water supplementation, prune juice, high-fibre diet, no-fibre diet (n = 1).
   
   Who: intervention trials (RCTs, non-randomized, uncontrolled) of foods, drinks and diets in adults with chronic constipation, searched to July 2023
   Effect: no papaya studies found; fruits vs psyllium MD +0.36 bowel movements/week (0.25-0.48), n = 232
   Certainty: The absence of papaya is a conclusion from the list of interventions in the abstract; children are not covered.
   Aliment Pharmacol Ther, 2024 · checked 2026-10-07 · we read the abstract
2. ev-pac-02 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 11 RCTs
   Totally, fruits vs. placebo did significantly increase the stool frequency of patients with FC in the fixed-effect meta-analysis [MD = 0.26, 95% CI (0.22, 0.30), P < 0.00001, Figure 2].
   
   Who: randomized parallel and crossover trials of fruit interventions in functional constipation, seven databases to July 2022
   Effect: fruits vs placebo stool frequency MD 0.26 (95% CI 0.22-0.30), P < 0.00001, I2 = 0; no papaya trial included
   Certainty: The absence of papaya was checked by searching the whole full text of PMC9583540; the effect is mostly from kiwi and does not transfer to papaya.
   Frontiers in Nutrition, 2022, 9:1018502 (Effect of fruit intake on functional constipation: a systematic review and meta-analysis) · checked 2026-10-07 · we read the fulltext
3. ev-pac-03 · Randomized controlled trial(s) · randomized double-blind placebo-controlled trial · n = 84 allocated (42 per arm); constipation item analyzed in 17 verum and 19 placebo early returnees
   In the verum group early returnees revealed statistically significant improvements of the symptoms "constipation" and "bloating".
   
   Who: volunteers in Vienna with chronic indigestion and gastrointestinal dysfunction, 1.4 tbsp (20 ml) Caricol papaya preparation (papain activity raised 3.75-fold in processing) or placebo daily for 40 days
   Effect: constipation improved in 82% (verum) vs 47% (placebo), p = 0.031; painful straining bowel movements 93% vs 50%, p = 0.016; no significant benefit in late returnees after washout
   Certainty: A manufactured preparation, not fresh papaya; self-assessment by questionnaire; numbers from table 5 of the full text (nel.edu PDF); in the pilot, raw papaya puree was rejected; the authors are affiliated with I-GAP, sponsorship not disclosed in the text.
   Neuro Endocrinology Letters, 2013, 34(1):38-46 (Muss, Mosgoeller, Endler) · checked 2026-10-07 · we read the abstract
4. ev-pac-04 · Randomized controlled trial(s) · randomized double-blind placebo-controlled trial · n = 60
   However, the pain load reduction in the Caricol®-Gastro group was significantly larger (p=0.048).
   
   Who: patients with endoscopically confirmed mild chronic gastritis, Caricol-Gastro (papaya and oats) 20 g twice daily for 30 days as add-on therapy
   Effect: pain load reduction larger with Caricol-Gastro than placebo (p = 0.048); strong placebo effect in both groups
   Certainty: Gastritis and pain, not constipation; a mixture with oats, the contribution of papaya is not separated; the same group of researchers as ev-pac-03.
   Neuro Endocrinol Lett, 2018 · checked 2026-10-07 · we read the abstract
5. ev-pac-05 · Observational data · controlled oral challenge study (double-blind, non-randomized) · n = 500 tested; 5 confirmed
   Papain-induced symptoms included palatal itching, watering itchy eyes, sneezing, rhinorrhea, abdominal cramps, diarrhea, and diaphoresis.
   
   Who: allergy clinic patients skin-prick tested with papain; skin-test-positive subjects underwent double-blind placebo-papain oral challenges
   Effect: confirmed papain sensitivity in 1.05% of allergic subjects; all 5 papain challenges positive, placebo negative
   Certainty: Papain as a food additive/enzyme preparation, not fresh papaya; 1985.
   Ann Allergy, 1985 · checked 2026-10-07 · we read the abstract
6. ev-pac-06 · Observational data · prospective clinical study · n = 25
   The most frequent food hypersensitivities were to avocado (9), chestnut (9), banana (7), kiwi (5) and papaya (3).
   
   Who: outpatients diagnosed with IgE-mediated latex allergy, Spain, mostly women in greenhouse and hospital work
   Effect: 42 food allergies in 13 patients (52%), 23 of them systemic anaphylaxis; papaya 3 cases
   Certainty: Small series; papaya was not included in the RAST inhibition of cross-reactivity.
   Ann Allergy, 1994 · checked 2026-10-07 · we read the abstract
7. ev-pac-07 · Observational data · cohort study · n = 250
   Infrequent users (1 kind of herb for <4 times per week and nonusers) were more likely to have an international normalized ratio within the optimal therapeutic range (2.0-3.0) than frequent users (>1 kind of herb for ≥4 times per week) (58.1% vs 51.1%, P = 0.046).
   
   Who: patients with nonvalvular atrial fibrillation on warfarin for at least 6 months, Hong Kong, mean age 69
   Effect: time in INR range 2.0-3.0: frequent herb users 51.1% vs infrequent users 58.1% (P = 0.046); papaya eaten by 55.2%
   Certainty: Papaya within a general basket of "herbs"; the separate effect of papaya was not assessed.
   J Cardiovasc Pharmacol, 2011 · checked 2026-10-07 · we read the abstract
8. pap-c4-06 · Observational data · cross-sectional descriptive observational study · n = 11
   Papain, chymopapain, caricaine and class I chitinases are papaya's most allergenic proteins. ... Hypersensitivity to papaya increases the risk of anaphylaxis in patients with latex allergy and, therefore, mortality.
   
   Who: 11 patients aged 7 to 46 years in Mexico with skin-prick-confirmed latex allergy and clinically diagnosed papaya anaphylaxis
   Effect: papaya-induced anaphylaxis was the reason all 11 were included; 72.7% female; 63.6% allergic to other foods, 45.4% to medications; risk factors were multiple surgeries, another allergic disease and health-sector work
   Certainty: case series without a control group, so it describes who is affected, not how often; the conclusion about mortality is the authors' inference. Spanish-language article, abstract in English
   Rev Alerg Mex, 2018 · checked 2026-09-23 · we read the abstract