Take this cautionary medical tale to heart and cool it with the ghost peppers
EC: Don't Burn a Hole in Your Esophagus with Hot Peppers
Credit: Photo by Debbi Smirnoff via Getty Images

Fellow mortals, are we truly so inured to the simple pleasures of life that we’re actually eating peppers hot enough to burn holes in our internal organs? That’s precisely what happened to an unnamed 47-year-old man cited in a case study by the Journal of Emergency Medicine. He consumed a ghost-pepper-topped burger that left a 2.5-centimeter tear in his esophagus—an injury so severe that he was intubated for 14 days and hospitalized for 23 days. He ate this pepper in a contest with, presumably, other adult human beings who were also attempting this feat. Soon after, the man was reportedly suffering “severe abdominal and chest pain subsequent to violent retching and vomiting.”

The publication included the case of spontaneous esophageal rupture, or Boerhaave syndrome, because it was important to remind emergency physicians that a potentially life-threatening surgical emergency might initially be interpreted as reasonably-expected discomfort after a large spicy meal.

For perspective, Tabasco sauce —which you should totally be putting on your morning oatmeal for a whole host of reasons—has about 2,500–5,000 Scoville heat units. Jalapenos—marvelous in omelets, hashes, and huevos rancheros—top out around 10,000 SHU. The scale was invented in invented in 1912 by pharmacist Wilbur Scoville, and diluted an alcohol-based extract with a pepper until they no longer tasted hot to the human tongue. The process has since been updated so scientists can measure parts per million of the heat-bringing alkaloids and multiply that by 16 to reach a Scoville rating, without harming any human tongues. Say, like on a ghost pepper—a.k.a. Bhut Jolokia or Naga Jolokia—which hovers around 1,000,000 SHU.

Why would a human self-inflict this pain? Was there nothing good on Netflix? Had all the marathons been run, mountains climbed, crushes revealed, so this was a risk worth internal impairment? Here’s a cautionary tale: Chef Chris Cosentino of Boccalone and Coxcomb in San Francisco did a stint on a reality show called Chefs vs. City, where he participated in food-based challenges with chefs in cities around the country. Several of these entailed eating whole ghost peppers, or dishes involving multiple chiles. His health began to suffer and his doctors feared the worst—cirrhosis or cancer—before discovering that Cosentino’s stomach was covered in third-degree alkaline burns, likely caused by the peppers. Nerve endings were dead, and his stomach failed to push the food into his intestines for further digestion, so it sat there and fermented, affecting his physical and emotional health almost to the breaking point. (He’s much, much better now.)

I get the appeal of a little capsaicin rush, and I especially dig it at breakfast. It kicks off my day with a sensory thrill and sends me into the day alert and delighted. Plus, pro tip: if you get your spice in at breakfast, you’re upright and moving around and not trying to recline or sleep with all that heat and acid washing back upward. But I also want to live to see the afternoon.