Red hot chili peppers do not worsen hemorrhoid symptoms
Clinical QuestionDoes eating spicy foods -- red hot chili peppers, specifically -- exacerbate hemorrhoid symptoms?
Bottom LineThis study found no evidence to support the popular contention that spicy foods, including red hot chili peppers, exacerbates hemorrhoid symptoms. Clinicians need not warn patients with hemorrhoids to avoid spicy foods. (LOE = 1b)
ReferenceAltomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: The explosion of a myth: Results of a prospective, randomized, placebo-controlled trial. Dis Colon Rectum 2006;49:1018-1023. [PMID:16708161]
Study DesignRandomized controlled trial (double-blinded)
FundingSelf-funded or unfunded
SynopsisSpicy foods are frequently blamed by patients and clinicians for deleterious and explosive exacerbations of hemorrhoid symptoms. The investigators identified 50 adults (aged 37-57 years) affected by second-degree or third-degree hemorrhoids. Subjects randomly received (concealed allocation assignment) 2 identical blue capsules containing red hot chili pepper powder or placebo cellulose. The quantity of red hot chili pepper powder equaled the amount necessary to make a normal dish "spicy enough," as defined by the Association of Teachers of Italian Cuisine (equal to the "tip of the knife"). After baseline evaluation, patients consumed 1 of the capsules during the course of a regular meal. One week later, they repeated the treatment taking the other capsule. Subjects were instructed to avoid other foods potentially related to gastrointestinal symptoms, such as alcoholic drinks, coffee, and chocolate. Using a 10-cm visual analog scale, subjects scored the severity of hemorrhoid symptoms, such as bleeding and swelling, itching, pain, and anal burning before and 6, 24, and 48 hours after capsule ingestion. Both patients and clinicians remained unaware of the content of each capsule. Fortunately, hemorrhoid symptoms were low at baseline and remained low in all patients throughout the study, with no significant differences detected between the red hot chili pepper or placebo groups. The study was 90% powered to detect a 5% difference in hemorrhoid symptoms.
Barry, Henry, et al., editors. "Red Hot Chili Peppers Do Not Worsen Hemorrhoid Symptoms." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426763/all/Red_hot_chili_peppers_do_not_worsen_hemorrhoid_symptoms.
Red hot chili peppers do not worsen hemorrhoid symptoms. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426763/all/Red_hot_chili_peppers_do_not_worsen_hemorrhoid_symptoms. Accessed June 7, 2023.
Red hot chili peppers do not worsen hemorrhoid symptoms. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426763/all/Red_hot_chili_peppers_do_not_worsen_hemorrhoid_symptoms
Red Hot Chili Peppers Do Not Worsen Hemorrhoid Symptoms [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 June 07]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426763/all/Red_hot_chili_peppers_do_not_worsen_hemorrhoid_symptoms.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Red hot chili peppers do not worsen hemorrhoid symptoms ID - 426763 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426763/all/Red_hot_chili_peppers_do_not_worsen_hemorrhoid_symptoms PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -