It is often said of hot peppers that they will burn you twice; once on the way in, and once on the way out.
But sometimes a pepper is so spicy, and so recklessly consumed, that it can literally burn you before even reaching its final destination. Sure, we've all heard horror stories of capsaicin causing hallucinations, asphyxiation, evacuations, and even killing those who do not treat it with deference, but sometimes, hot peppers can straight-up burn a hole through the human body.
This might sound like the stuff of urban legend, but it's not. According to a case report recently published in the Journal of Emergency Medicine, a 47-year-old American man was admitted into the ER after having consumed a _bhut jolokia_-laced burger during a hot-pepper-eating contest.
Bhut jolokia is the Assamese word for million-plus-Scoville-unit ghost peppers, made famous in the West by hot sauces promising near-death experience to those who consume them. Apparently, those promises are not empty.
The medical report, entitled "Esophageal Rupture After Ghost Pepper Ingestion," tells the tale of an unnamed man showing up at the ER with severe abdominal and chest pain following an episode of "violent retching and vomiting." After giving him an X-ray and surgery, doctors also found a 2.5 centimeter tear in his esophagus that was filling up with "food debris."
In fact, the ghost peppers wreaked such havoc on the chili challenger's body that he spent 23 days in the hospital and was discharged with a gastric tube still inside of him.
So, why write about this food contest gone wrong in a medical journal?
Well, first off, it confirms that hot peppers could potentially kill you by tearing a hole into your insides. And with the recent interest in insanely hot sauces and peppers, doctors also need to know how to deal with people who enter hot sauce competitions and go way too far. Odds are, this is not the last time we will hear of someone requiring emergency medical attention after eating too much spicy food.
"Spontaneous esophageal rupture, Boerhaave syndrome, is a rare condition encountered by emergency physicians, with a high mortality rate," the authors of the case report wrote. "This case serves as an important reminder of a potentially life-threatening surgical emergency initially interpreted as discomfort after a large spicy meal."
While the esophagus-burning ghost pepper may not be an urban legend, it certainly is a cautionary tale and a reminder that hot peppers are not something to be fucked with.