A hot topic: Are spicy foods healthy or dangerous?

Spicy foods

I’ve met too many people who swear that eating spicy foods is dangerous. Patients often tell me they've giving up spicy foods to get healthy. When my wife and I let our kids eat something spicy, my in-laws shake their heads at us. However, last time I checked, having a little Tabasco sauce won't ruin your life.

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 eating spicy foods to separate fact from fiction.

Are spicy foods healthy? Of course they are!

Capsaicinoids, which include the compound capsaicin, are the chemical components of peppers that create their spicy taste. Research over the past couple of decades has demonstrated that capsaicinoids — and thus, spicy foods — also possess several health benefits.

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 percent 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.

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, capsaicin has been considered 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 gastrointestinal (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.

Spicy foods don’t cause hemorrhoids, but they may irritate anal fissures

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.

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.

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 more than 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. 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 ruptured his esophagus.

Granted, the rupture was likely due to the vomiting, not from direct effects of the spicy peppers. But, the crazy hot peppers definitely triggered the vomiting.

Okay, 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 (or, indigestion). For people with irritable bowel syndrome (IBS), spicy foods can also trigger symptoms.

Another study showed that “those consuming spicy foods greater than or equal to 10 times per week were 92 percent 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 with irritable bowel symptoms in men.

In people with inflammatory bowel disease (or, IBD — Crohn’s disease or ulcerative colitis), spicy foods can also trigger some symptoms.

Dr. Ed, what’s the bottom line?

  • Spicy foods are healthy.
  • Spicy foods don’t cause ulcers, but be careful if you have irritable bowel syndrome, dyspepsia, or inflammatory bowel disease (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.
  • Regarding ridiculously spicy foods with warning labels, eat them at your own risk. Fellas, that ghost pepper sauce almost burned off my chest hairs from the inside—respect it.
author details Edwin McDonald

Edwin McDonald IV, MD

Edwin K. McDonald IV, MD, is dedicated to improving the health of individuals and communities through nutrition education.

Learn more about Dr. McDonald