Hektoen International

A Journal of Medical Humanities

The pains and pleasures of spicy food

Danielle Dalechek
Norfolk, Virginia

Human tongue. Macroscopic Solutions. Wellcome Collection. CC BY-NC 4.0.

Do you enjoy the painful yet delightful sensation of spicy chili peppers making your mouth feel as if it were on fire? Are you a fan of eating dishes that make your eyes tear and your nose run? If so, it is probably because red pepper contains capsaicin, the substance that gives it its spicy flavor.1

What does “spicy” mean, exactly? From a culinary and sensory perspective, tastes—bitter, salty, sour, sweet and umami (savory)—are all sensations carried to the brain by the glossopharyngeal, facial, and vagus nerves. However, “spicy” is actually registered by the trigeminal nerve instead of the taste buds. Spicy food causes pain, burning, and even a numbing sensation depending on the level of Scoville Heat Units (SHU) because it contains chemicals that irritate and stimulate nociceptors in the mouth. These factors combine to result in the process of chemesthesis, which is the chemical sensibility of the skin and mucous membranes. In other words, spicy food is a painful sensation, but we seem to enjoy willingly suffering for it.

There are no clear benefits to eating jalapeños every day, and it might be dangerous to consume spicy food in excess amounts. Still, some studies have claimed that “compared with those who ate spicy foods less than once a week, those who consumed spicy foods six or seven days a week showed a 14% relative risk reduction in total mortality.” The caveat being you have to make sure that you are not a spicy food lover and also an alcoholic. Studies have found a correlation between alcoholism, addiction, and enjoyment of consuming spicy food. Still, such pleasures are too positive to ignore, especially since peppers and similar ingredients are a fundamental part of the culinary culture in many diverse regions of the world.

Where is capsaicin found?

Capsaicin is mainly found in capsicum, known globally by a variety of names such as “pepper, chili, chile, mirchi, and paprika.”2 It is part of the daily diet in places like India and Mexico. Tourists not accustomed to this diet often cannot handle the strength of different variants of red chili pepper.

Spicy dishes are not only integral to the taste and cultural value of food in different parts of the world, but they also have some nutritional value. For example, a green chili pepper has a larger concentration of vitamin C than lemons and other citrus fruits, and there is more vitamin A in a red chili than in a carrot.3 Other examples of spicier choices with great benefits are ginger and curcumin. Some studies even claim that garlic, ginger, and turmeric reduce blood cholesterol;2 which brings to mind the traditions of prescribing tea infusions of ginger root or even cayenne for health treatments.

There are reported health benefits of capsaicin, but there is also research that correlates the enjoyment of spicy food with alcohol consumption. The central opioid system, responsible for regulating activity of the mesolimbic dopamine pathway is linked to drug dependence and addiction in general.4 When this system interacts with capsaicin, it increases its activity in the brain. This does not necessarily mean that eating enchiladas on a Friday evening will compel you to go to the nearest happy-hour afterwards and overindulge. But for those with a propensity towards heavy drinking habits, spicy food might give an additional push into addictive behaviors.

This can become especially problematic if there are concurrent conditions such as ulcerative colitis (UC), where both alcohol and spicy food are often contraindicated. Higher consumption of spicy foods may induce stomach fullness and exacerbate symptoms of UC, which was found to be especially true in young women.5 It also aggravates cases of anal fissures, when present.6

Considering how food with capsaicin can have a tendency to make some symptoms worse, it is not surprising that many doctors suggest that patients with UC abstain from spicy food. However, although studies have shown that capsaicin can aggravate certain symptoms, it does not cause gastric ulcers, and is only problematic for a select number of persons.7 Accordingly most people could safely incorporate capsicum into their diets, at least in small amounts, to spice up their food. Even people suffering from alcohol dependency could try incorporating it in small quantities and observe how it may or may not affect their dependency.

In recent years capsaicin has found uses outside of the culinary environment and has been applied topically to treat post-herpetic neuralgia, diabetic neuropathy, osteoarthritis, and even rheumatoid arthritis.8 Further research is needed to evaluate the efficacy of such regimens and perhaps reveal new insights for neuroscience. Meanwhile anyone in the pursuit of a more flavorful life might consider including these wonderful and often delightfully painful substances into their daily diet.


  1. Lu M, Ho CT, Huang Q. Extraction, bioavailability, and bioefficacy of capsaicinoids. Journal of Food and Drug Analysis. 2017 Jan;25(1):27-36. doi: 10.1016/j.jfda.2016.10.023.
  2. Saxena A, Raghuwanshi R, Gupta VK, Singh HB. Chilli Anthracnose: The Epidemiology and Management. Front Microbiol. 2016;7:1527. Published 2016 Sep 30. doi:10.3389/fmicb.2016.01527
  3. Ibid
  4. Park JH, Kim SG, Kim JH, Lee JS, Jung WY, Kim HK. Spicy Food Preference and Risk for Alcohol Dependence in Korean. Psychiatry Investig. 2017;14(6):825–829. doi:10.4306/pi.2017.14.6.825
  5. Lee SY, Masaoka T, Han HS, Matsuzaki J, Hong MJ, Fukuhara S, Choi HS, Suzuki H. Neurogastroenterol Motil. 2016 Sep;28(9):1401-8. doi: 10.1111/nmo.12841. Epub 2016 Apr 19.
  6. Gupta PJ. Consumption of red-hot chili pepper increases symptoms in patients
    with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial. Arq Gastroenterol. 2008 Apr-Jun;45(2):124-7. PubMed PMID:18622465.
  7. Satyanarayana MN. Capsaicin and gastric ulcers. Crit Rev Food Sci Nutr.
    2006;46(4):275-328. Review. PubMed PMID: 16621751.
  8. Lu M, Ho CT, Huang Q. Extraction, bioavailability, and bioefficacy of capsaicinoids 27-36.

DANIELLE DALECHEK lives on the Bay in Norfolk, VA, and is currently obtaining a Master’s in healthcare analytics from Eastern Virginia Medical School. She has always been interested in the relationship between neurogastroenterology and epigenetics, and although currently working as a medical communications writer, she has also worked in neuroscience and cardiology research. She enjoys cooking a variety of spicy foods, hiking, kayaking, reading, and making art for local shops or charity.

Highlighted in Frontispiece Volume 15, Issue 3 – Summer 2023

Spring 2019




Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.