Based on NIH | Does eating spicy food interfere with aspirin or increase the risk of stomach irritation or bleeding?

Spicy food and aspirin: what the evidence shows

• Short answer: Spicy food does not appear to directly interfere with how aspirin works, and in most people it does not independently raise the risk of serious stomach bleeding; the main bleeding risk comes from aspirin itself, alcohol, older age, prior ulcers, and certain medicines. ^{[1] [2]}
• That said, spicy foods can irritate sensitive stomachs and may worsen heartburn or gastritis symptoms in some individuals, so comfort‑based moderation makes sense if you notice symptoms.

How aspirin affects the stomach

• Aspirin is a nonsteroidal anti‑inflammatory drug (NSAID) that can irritate the stomach lining and increase the risk of stomach or intestinal bleeding. ^[1]
• Known factors that raise aspirin‑related bleeding risk include being age 60+, prior ulcers/bleeding, using anticoagulants or steroids, taking other NSAIDs, heavy alcohol use, higher doses, and longer duration. ^[1]
• Consumer drug labels advise taking aspirin with food or milk if stomach upset occurs and to stop and seek care for signs of bleeding (black stools, vomiting blood, persistent stomach pain, feeling faint). ^{[3] [4]}

Does spicy food increase bleeding with aspirin?

• Classic patient information on ulcers notes that stress and spicy foods do not cause ulcers; rather, long‑term NSAID use (including aspirin) and H. pylori infection are key causes. ^[5]
• Controlled endoscopy studies in healthy volunteers found that eating highly spiced meals did not produce visible mucosal injury, whereas aspirin caused multiple erosions; only isolated minor erosions were seen after spicy meals. ^[6]
• Another human study showed that ingesting chili before aspirin actually reduced aspirin‑related endoscopic injury scores, suggesting a potential “gastroprotective” effect of chili in that setting. ^[7]
• Older physiologic studies reported that red or black pepper increased gastric secretions and caused transient microbleeding in some volunteers; however, the long‑term significance is unclear and aspirin at typical test doses produced comparable or greater effects. ^[8]
• Putting these findings together, spicy food by itself is unlikely to materially increase serious bleeding risk when compared with the established risks from aspirin and other known factors, though individual sensitivity varies. ^{[1] [6] [7] [8]}

Interactions between spicy components and aspirin

• Capsaicin (the “hot” component of chili) has shown protective effects on gastric mucosa against NSAID injury in animal models and some human experiments, likely via sensory nerve pathways. ^{[9] [7]}
• Early phase human work combining capsaicinoids with NSAIDs did not show adverse effects on aspirin absorption or antiplatelet action, though these were small studies and not routine clinical practice. ^[10]
• Mainstream clinical guidance does not list a direct drug–drug interaction between dietary spicy foods and aspirin’s antiplatelet effect. ^[11]

Practical advice if you take aspirin

• Consider taking aspirin with food or milk if you experience stomach upset. ^[3]
• Limit alcohol, as alcohol plus aspirin can increase stomach bleeding risk; ask your clinician what amount (if any) is safe for you. ^[12]
• Watch for warning signs: black/tarry stools, vomiting blood, persistent stomach pain, or feeling faint; seek medical care promptly if these occur. ^[3]
• If you have a history of ulcers/bleeding, are 60+ years old, or take blood thinners or steroids, talk with your clinician about stomach protection (for example, a proton pump inhibitor) and whether aspirin is appropriate. ^[1]
• If spicy foods trigger your heartburn or indigestion, it’s reasonable to cut back; symptom‑guided moderation is sensible since comfort and tolerance differ among people. ^[5]

Bottom line

• There is no strong evidence that typical consumption of spicy food directly increases aspirin‑related serious gastrointestinal bleeding risk, and some studies even suggest chili may blunt aspirin‑induced mucosal injury. ^{[7] [6]}
• The dominant drivers of bleeding risk are aspirin itself and established risk factors (age, ulcer history, anticoagulants/steroids, other NSAIDs, and alcohol), not spices. ^{[1] [12]}
• Still, if spicy dishes bother your stomach, it’s reasonable to reduce them and use general stomach‑friendly habits while taking aspirin. ^{[3] [5]}