HOT Chilies: Friend or Foe

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Recently, my husband, our teenage son, and I were watching an episode of Man vs. Food, on the Travel Channel. The host, Adam Richman, was taking on the food challenge of the "hottest chili sauce known to man". My son raised the question, "Is eating really hot spicy food bad for you?" My husband, a gastroenterologist, replied that spicy food did not damage the stomach. He had heard that capsaicin, which is the active component in chilies, was used to treat H. pylori. Helicobacter pylori (H. pylori) infection is caused by the bacterium, H. pylorus, which infects the stomach and the first part of the small intestines. Untreated, this infection can lead to ulcers and stomach cancer.

I searched for evidence. "Spicy Food and the Stomach" by David Y. Graham, MD is a case study of the effect of ingesting hot spicy foods. Dr. Graham and his associates conducted a trial of administering test meals offered at the noon and evening meal. Twelve individuals, eight men and four women, who ranged in age from 24 to 43, received a baseline endoscopy, were served all four of the test meals, and underwent a repeat endoscopy twelve hours after the last test meal was eaten. The meals included a negative control, which consisted of a bland meal, a positive control, which was a bland meal plus 1950 mg of aspirin, a spicy meal with 30 grams of jalapeno pepper, and a pepperoni pizza. The data showed that 11 of the 12 subjects taking the bland meal plus aspirin developed multiple gastric erosion and single cases of single erosion were present after the spicy meal and the pepperoni pizza meal.

Finally, approximately 30 grams of freshly ground jalapeno peppers were placed directly into the stomach. Endoscopic examination conducted twenty-four hours later revealed no visible mucosal damage. (1)

"Garlic or Jalapeno Peppers for Treatment of Helicobacter pylori Infection" addresses the effect of garlic and jalapeno peppers in inhibiting H. pylori. Dr. Graham and his colleagues selected twelve individuals, seven males and five females, ages 27 to 51. A urea breath test to assess the status of H. pylori was administered, three test meals which included 10 slices of fresh garlic and 6 slices of fresh jalapeno were served, two tablets of bismuth subsalicylate (Pepto-Bismol) were given as a positive control, and nothing was added as a negative control. The conclusion was that neither garlic nor capsaicin had any in vivo effect on H. pylori although bismuth did have a marked inhibitory effect.

"Caution must be used when attempting to extrapolate data from in vitro (in test tubes) to the in vivo (among living organisms) condition", states David Y. Graham, MD

(1) "Spicy Foods and the Stomach Evaluation by Videoendoscopy"
David Y. Graham, MD, J. Lacey Smith, MD, Antone R. Openkun, PA-C
JAMA December 16, 1988

(2) "Garlic or Jalapeno Peppers for Treatment of Helicobacter pylori Infection"
David Y. Graham, MD, MACB, Sun-Young Anderson, PA-C, Thang Lang, MD
American Journal of Gastroenterology May 1999

Maryann Gromisch is a registered nurse with medical, surgical, and critical care nursing experience. She has worked with a gastroenterologist in a private practice setting, and been married to her husband, a gastroenterologist for 25 years.

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