I’ve met too many people who swear that eating spicy foods is more dangerous than having ‘Florida Man’ as your Uber driver. Anytime my in-laws see my kids eating something spicy, they look at my wife and I like we’re letting our kids play in a sandbox filled with cocaine. Speaking of cocaine (you have to love that transition), when I was a resident working at a VA clinic, I had the privilege of taking care of veterans who were trying to get their life together and overcome some of the hardships of war. My vets would come to my clinic eager to share updates about how they’re improving their lives. People would say things like, “I stopped using cocaine, I stopped drinking, I stopped cheating on my old lady, and I stopped eating spicy foods.” I would hear these stories and think to myself, “Whoa, since when did spicy foods become on par with infidelity and cocaine use?”
For the record, spicy foods are absolutely NOT on par with using cocaine or cheating on your spouse (both of those can be deadly). Last time I checked, unless your mistress is named Cholula, having a little Tobasco sauce in your life doesn’t end with marriage counseling and lawyer fees.
Nonetheless, there’s some confusion about whether spicy foods are healthy or dangerous. In this post, I want to shed some evidence-based light on spicy foods to clear up some of this confusion.
Are spicy foods healthy? Of course, they are. Let’s break it down.
Capsaicinoids are the chemical components of peppers that create their spicy taste. Research over the past couple of decades has demonstrated that capsaicinoids, thus spicy foods, also possess several health benefits.
1. Eating spicy foods may help you live longer.
According to an extensive population-based study published in BMJ in 2015, “Compared with those who ate spicy foods less than once a week, those who consumed spicy foods 6 or 7 days a week showed a 14% relative risk reduction in total mortality.” The association between spicy food consumption and total mortality “was stronger in those who did not consume alcohol than those who did.”
It’s ok to eat your spicy foods, but cut down on the margaritas with your spicy tacos.
2. Spicy foods don’t cause ulcers—they may actually help ulcers.
As a gastroenterologist, I diagnose people with ulcers all the time. When I tell someone they have an ulcer after a procedure, almost everyone is quick to blame spicy foods. People frequently ignore the fact they are taking ibuprofen ‘around the clock’ or that they may have a bacteria called H. Pylori (one of the world’s most common causes of ulcers).
Contrary to popular belief, multiple studies show that capsaicin actually inhibits acid production in the stomach. As a matter of fact, people have looked into using capsaicin as a medication for preventing ulcer development in people who take non-steroidal anti-inflammatory drugs.
If you’re worried about an ulcer, go see your friendly neighborhood GI doc (you can look me up if you’re in Chicago). Most importantly, when seeing your doc, make sure you have a conversation about any anti-inflammatory meds you’re using.
3. Spicy foods don’t cause hemorrhoids, but they may irritate anal fissures.
I remember back in 3rd grade, one of my classmates saw me putting hot sauce on some Jay’s Potato Chips (Chicagoans know what I’m talking about). He immediately yelled out, “Eddie is going to get hemorrhoids (people called me Eddie back then).”
That interaction is memorable since ‘hemorrhoids’ is such an odd thing for an 8-year-old to bring up—who does that? Even though I was a kid whose best friend was a World Book Encyclopedia, I had to ask my mom about hemorrhoids and hot sauce. When I asked her, she just responded by saying she needs to put me in private school.
This was the ‘burning question’ that put me on the path of becoming a gastroenterologist (not really, I just wanted to write ‘burning question’).
Apparently, I wasn’t the only person with this question because someone actually did a research study that evaluated the connection between spicy foods and hemorrhoids. In 2006, in a study published in Diseases of the Colon and Rectum, researchers randomly assigned people with large hemorrhoids to taking a placebo capsule or a capsule of red hot chili powder. The participants had to rate the effects of the pills on their hemorrhoid symptoms. The study found that the spicy capsules had no effect on hemorrhoid symptoms.
The story is a little different for people with small tears in the anus called anal fissures. Anal fissures are extremely painful—’make a grown adult cry’ painful. A study in 2008 demonstrated that spicy foods aggravate symptoms associated with anal fissures. In the study, patients were randomly given a week of placebo and a week of chili pepper capsules. They had to keep track of anal fissure symptoms over the study period. Eighty-one percent of the participants felt better on the placebo.
4. Spicy foods may help with weight loss.
C’mon, hot sauce can help you lose weight? It can, according to a meta-analysis of 90 different studies that looked at the role of capsaicin in weight management. The analysis found spicy foods reduce appetite and that they increase energy expenditure. In fact, the researchers observed that consumption of “capsaicinoids increases energy expenditure by approximately 50 kcal/day.”
Are spicy foods dangerous? It depends on how spicy. You’ve heard of pepper spray, right?
Not too long ago, I saw a show on YouTube called Hot Ones. The simplicity of the show is what makes it beautiful—it’s just a host interviewing celebrities while eating super spicy hot sauces. Some of the hot sauces are over 100 times hotter than Tabasco sauce. I guess I was a victim of ‘toxic masculinity’ because my testosterone levels made me try one of the hottest sauces on the show. It was one of those sauces that comes with a warning label. On the show, they dabbed a wing in one drop of the sauce. I foolishly poured a small amount on an organic tortilla chip (it was more than a dab).
The first bite was cool. I felt some heat with the second bite. My tongue died with the third bite. It felt like I was a vampire who just took a bite out of the devil. It felt like I was gargling with lava. After 10 seconds of tongue melting pain, I truly think I passed out and started hallucinating.
Honestly, I swear I had an out of body experience and I went a vision quest. On my capsaicin-induced trip, I ran into one of my African ancestors. I thought he was going give me some life-altering knowledge—nope. All he said was, “Dude, you didn’t see the warning label on the bottle?” That’s when I woke up on my kitchen floor in severe pain with my wife staring at me with the side-eye of matrimonial shame.
After guzzling a gallon of milk, eating a loaf of bread, and going to my prayer closet—I decided to look up the dangers of ridiculously spicy foods.
A case of esophageal perforation after eating ghost peppers.
The hot sauce I ate was ghost pepper based. When I started my search for dangers of super spicy foods, the first article I came across was from the Journal of Emergency Medicine. It was about a guy who ate ghost peppers as part of a contest. He started vomiting violently (I’ve been there). He eventually vomited so hard that he eventually ruptured his esophagus.
Granted, the rupture was likely due to the vomiting, not from any direct effects of the spicy peppers. But, the crazy hot peppers definitely triggered the vomiting.
Alright, Doc you said spicy foods don’t cause ulcers, but I swear I have belly pain every time I eat spicy foods. What’s up with that?
Although spicy foods don’t cause ulcers, they can trigger abdominal pain in some people. One study specifically highlighted that frequent consumption of spicy foods can trigger upper gastrointestinal symptoms in some people with dyspepsia. For people with irritable bowel syndrome, spicy foods can also trigger symptoms. Another study showed that “those consuming spicy foods ≥ 10 times per week were 92% more likely to have IBS compared with those who never consumed spicy foods.” When the researchers tried to analyze this finding based on gender, they found that spicy foods were not associated irritable bowel symptoms in men.
In people with inflammatory bowel disease (Crohn’s Disease or Ulcerative Colitis), spicy foods can also trigger some symptoms.
Dr. Ed, What’s the bottom line?
- Spicy foods are healthy
- They don’t cause ulcers, but be careful if you have irritable bowel syndrome, dyspepsia, or IBD. Basically, if spicy foods give you belly pain, think before you eat.
- Spicy foods don’t cause hemorrhoids, but you may feel the burn if you have anal fissures.
- Don’t get spicy foods in your eyes
- Use gloves if handling super hot peppers
- Know your Scoville units
- Regarding ridiculously spicy foods with warning labels, eat them at your own risk. Fellas, that ghost pepper sauce almost burnt off my chest hairs from the inside—respect it.
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I am a physician and trained chef. I specialize in gastroenterology and nutrition. Currently I work as the Associate Director of Adult Nutrition at the University of Chicago.