Chilli eating challenges: a health warning

Eating extremely hot chillies for a contest, a dare or a video can make you seriously ill. Health agencies have warned against it. This page sets out what they and doctors have reported.

This is general information, not medical advice. If you are unwell after eating chilli, see the section on getting help below.

What the health agencies say

The French food safety agency, ANSES (no date), warns against social media challenges that involve eating extremely spicy foods or the "world's hottest" chillies. It says large amounts of capsaicin, the compound that makes chillies hot, can cause:

• pain along the digestive tract, from the mouth to the stomach;
• nausea, vomiting and diarrhoea;
• high blood pressure, a racing heart or loss of consciousness;
• skin redness after contact, and red, watering or damaged eyes;
• allergic reactions, including swelling of the face and throat.

ANSES (no date) says children and people with digestive or heart conditions are especially sensitive. Its figures for France from 2021 to 2025 show 124 people contacted a poison centre after eating spicy food. A third of them were teenagers aged 10 to 15, and 39 per cent of the cases involved a challenge. All the cases were mild except one: a woman with a history of allergies had swelling of the face and throat after eating a spicy crisp as part of a challenge, and recovered with treatment. ANSES also reports that in 2023 a 14-year-old American with a mild heart defect died from cardiorespiratory arrest after eating an extremely spicy crisp, and that since 2023 six food products have been withdrawn from the European market for excessive capsaicin or non-compliant labelling.

The German Federal Institute for Risk Assessment (BfR) reviewed the research in a June 2024 opinion (BfR, 2024). It concluded that an increased risk of damage to the lining of the stomach can be assumed even at amounts you can reach by eating very spicy food in the normal way. Symptoms range from a burning feeling in the upper digestive tract, heartburn and reflux to nausea, vomiting and pain in the abdomen and chest, and high intakes can cause cold sweats, changes in blood pressure and dizziness. The BfR says the evidence is still too thin to name a dose above which this happens, that the same amount eaten in one go, such as a single very hot corn chip, may hit harder than the same amount spread through a meal, and that the EU and Germany have no legal limits on capsaicinoids in food. It advises caution with extremely hot chilli sauces and chilli extracts.

The BfR also asked German poison information centres about cases linked to very spicy products such as hot corn chips. They recorded 73 enquiries up to October 2023, most about children and adolescents: 55 with mild symptoms, 8 moderate, 7 with none, and 3 that could not be assessed. Spicy chips or similar products were the source in 40, and where the amount was reported it was generally one chip or less. A further 32 enquiries followed between November 2023 and March 2024. The BfR notes these reports do not show how much capsaicin was eaten (BfR, 2024).

Cases doctors have reported

These are rare, and most people who eat a very hot chilli will only have pain and discomfort. But they show what can go wrong.

• A torn gullet. In a case reported by Arens et al. (2016), a 47-year-old man ate ghost peppers, with a burger, as part of a chilli eating contest and then had severe abdominal and chest pain after violent retching and vomiting. Doctors found a 2.5 cm tear in the lower part of his oesophagus, a rare condition called Boerhaave syndrome. He was taken straight to surgery, came off the breathing tube on day 14, and went home with a feeding tube on day 23. His doctors described it as a potentially life-threatening surgical emergency, and wrote that they knew of no earlier report of significant harm from eating ghost peppers.
• Severe headaches. In a case reported by Boddhula et al. (2018), a 34-year-old man ate one Carolina Reaper at a hot pepper contest and had dry heaves straight afterwards. He then had intense neck and head pain, and over the next few days brief, excruciating "thunderclap" headaches lasting seconds. A scan of the blood vessels in his brain showed narrowing in several arteries, and his doctors made a presumptive diagnosis of a rare condition called reversible cerebral vasoconstriction syndrome. He improved with supportive care, and a scan five weeks later showed the narrowing had gone. The authors said no earlier case linked to peppers had been reported and that a link was "plausible". This was a single case, so it suggests a possible link and does not prove the chilli was the cause.
• A teenager with a stroke. A 2020 case report by Taylor et al. (2020, cited in BfR, 2024) describes a 15-year-old boy in the United States who had severe headaches and very high blood pressure after two days of eating Carolina Reaper peppers as part of a courage test. Doctors diagnosed the same rare blood vessel condition, together with a stroke (a cerebral infarction) and swelling of the outer layer of the brain. The amount he ate is not known.
• Severe stomach pain, in hospital. A 2020 case report by Koprdova et al. (2020, cited in BfR, 2024) describes a 27-year-old man who had severe abdominal pain about two and a half hours after eating four Bhut Jolokia (ghost pepper) chillies and other extremely spicy foods as part of a qualification for a chilli eating competition. He was taken to hospital. The BfR estimates he had eaten at least 600 mg of capsaicin. Other tests were largely normal, and he improved with painkillers within 30 hours. The BfR calls it the best documented case (BfR, 2024).

The BfR cautions that, apart from that 600 mg case, reports like these are hard to interpret in terms of cause, because the amount eaten is usually not known (BfR, 2024).

If you are thinking of taking part

• Do not treat very hot chillies, extract-strength sauces or "challenge" snacks as a dare. The agencies above advise avoiding these challenges (ANSES, no date; BfR, 2024).
• Do not let children or teenagers take part, and talk to young people about the risks. Keep very hot chillies and sauces away from children and pets.
• Take extra care if you have heart, breathing or digestive conditions, or allergies. If in doubt, ask a doctor first.
• Pepper spray and pure capsaicin appear on our chart only to show the top of the scale. They are not food and must never be eaten.

If you do feel unwell

The NHS treats swallowing something harmful as possible poisoning and says to get medical advice immediately (NHS, 2025). We are not medical professionals, and the NHS page does not mention chillies, but chilli eaten in large amounts can be harmful, as the cases above show.

• In the UK, call 999 or go to A&E if you think you or someone else has swallowed something harmful and are seriously unwell, for example with a sudden severe headache, chest pain, vomiting that will not stop, severe difficulty breathing, a seizure or loss of consciousness (NHS, 2025). The cases reported by Arens et al. (2016) and Boddhula et al. (2018) involved severe pain, vomiting and headache. Do not wait to see if it passes. The NHS advises against driving yourself: ask someone to drive you, or call 999 and ask for an ambulance.
• If you are not sure whether it is serious, call NHS 111 (NHS, 2025). Elsewhere, use your local emergency number (for example 112 across Europe, 911 in the United States).
• Swelling of the face or throat, or difficulty breathing: call your emergency number straight away. ANSES lists allergic reactions, including swelling of the face and throat, among the effects (ANSES, no date).
• Do not try to make yourself or anyone else sick, and do not give them anything to eat or drink while waiting for help (NHS, 2025). The doctors who reported the torn oesophagus noted that this life-threatening emergency was at first mistaken for discomfort after a large spicy meal (Arens et al., 2016).
• For the burning alone (no other symptoms), ANSES advises a fatty food such as milk, yoghurt or edible oil, or a starchy food such as bread, potatoes or rice, and advises against water or fizzy drinks because capsaicin does not dissolve in water. If pain lasts or gets worse, speak to a doctor or a poison centre (ANSES, no date).

References

• Arens, A., Ben-Youssef, L., Hayashi, S. and Smollin, C. (2016) 'Esophageal rupture after ghost pepper ingestion', Journal of Emergency Medicine, 51(6), pp. e141–e143. Available at: https://doi.org/10.1016/j.jemermed.2016.05.061. Also at: https://pubmed.ncbi.nlm.nih.gov/27693067/.
• Boddhula, S.K., Boddhula, S., Gunasekaran, K. and Bischof, E. (2018) 'An unusual cause of thunderclap headache after eating the hottest pepper in the world: "The Carolina Reaper"', BMJ Case Reports, 2018, article bcr2017224085. Available at: https://doi.org/10.1136/bcr-2017-224085. Also at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5893965/.
• French Agency for Food, Environmental and Occupational Health and Safety (ANSES) (no date) Hot pepper challenges: a dangerous trend. Available at: https://www.anses.fr/en/news/hot-pepper-challenges-dangerous-trend (Accessed: 11 October 2026).
• German Federal Institute for Risk Assessment (BfR) (2024) High capsaicin levels can harbour health risks. Opinion No. 027/2024, 21 June. English translation; the German text is the legally binding version. Berlin: BfR. Available at: https://doi.org/10.17590/20240704-110826-0 (Accessed: 11 October 2026).
• NHS (2025) Poisoning. Page last reviewed 12 June 2025. Available at: https://www.nhs.uk/conditions/poisoning/ (Accessed: 11 October 2026).

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