Man Goes to Emergency Room, Tested for Brain Damage after Eating World's Hottest Chili Pepper

Eating extremely spicy food may cause much greater discomfort than a burning tongue or watery eyes. A man who decided to eat what's known as the world's hottest chili pepper, the Carolina Reaper, went to the emergency room after experiencing striking, severe head pain for days. 

The 34-year-old man's reaction to the pepper began with pain and dry heaves, but the repeated headaches led him to seek emergency care. “Initially, when he ate the chili pepper, he got the pain immediately,” Dr. Kulothungan Gunasekaran, an internist at Henry Ford Hospital in Detroit who was involved in the man’s case, told Newsweek. “He waited for a few days but kept on getting a headache again and again, so he came to the ER."

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Tests for various neurological problems came back negative, but a CT scan revealed that arteries in the man's brain were constricted. This led his primary neurologist, Dr. Gregory Cummings, to diagnosis him with thunderclap headaches—uncommon, extreme head pain that claps like thunder—caused by reversible cerebral vasoconstriction syndrome, a temporary artery narrowing in the brain.

4_9_CT BMJ In Figure A, a CT scan shows narrowed arteries in the brain of a man who ate the world's hottest chili pepper. In Figure B, a CT scan reveals that his arteries returned to normal size five weeks after supportive treatment, including IV fluids and pain medication. Credit: BMJ Case Reports 2018

Although a situation like this is rare and possibly the first to be documented, it is important to note that it is possible, said Gunasekaran, who co-authored a description of the man's symptoms, diagnosis, treatment and followup that was published Monday in BMJ Case Reports.

“The public should be aware that they might get [severe symptoms] after eating peppers, such as the Carolina Reaper,” Gunasekaran explained. “If you do begin to experience these symptoms, you should go to the emergency room immediately because if the [blood vessel constriction] occurs in the heart it can lead to heart attack and if in the brain, it can cause a stroke.”

The man recovered after receiving a combination of IV fluids, pain medication and close monitoring. Within five weeks, his arteries returned to their normal size.

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The Carolina Reaper earned the title of hottest chili pepper in the world because it has more capsaicinoids—a class of compounds which produces the spicy effect—than any other peppers.

“You might try a pepper and have the tip and think that it’s OK. But it’s actually the tip that has the lowest amount of capsaicin,” Dr. Nancy Rahnama, a bariatric physician in Beverly Hills who was not involved in the case, told Newsweek. “It’s when you reach the stem of the pepper that it actually multiples to the thousands in the amounts of capsaicin.”

4_9_chili pepper Three competitors, who are not involved in this story or case report, are seen participating in a chili pepper eating competition in Ningxiang, China. STR/AFP/Getty Images

Although people should be cautious of eating capsaicin, it can also help boost metabolism, promote weight loss and decrease joint pain, she notes. However, as for the Carolina Reaper, it’s probably best to stay away.

“People are trying to show how tough they are by having these contests where they eat these peppers or want to prove a point. This case is the perfect example that you need to watch out and listen to your body,” Rahnama advised.