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4]. One of the significant pathophysiologies of IBS is visceral hypersensitivity, which has been known to have both mechanical and chemical causes. Indeed, sensory neurons have been linked to IBS [5]. Because postprandial gastrointestinal symptoms have been reported to develop in a significant number of patients following consumption of spicy food, Gonlachanvit et al. [2] conducted a randomized, crossover study feeding subjects with and without IBS subjects and found that IBS patients were significantly more likely to exhibit hypersensitivity when chili, both in pill form and in food form, was consumed [2]. This observation has been further supported by recent mechanistic studies involving capsaicin, the active component of chilies. Akbar et al. [6] performed rectosigmoid biopsies of 23 IBS patients in addition to 22 controls and found a 3.5-fold increase in the median number of TRPV1-expressing (the capsaicin receptor) nerve fibers in IBS patients compared to non-IBS controls. Although study has been done focusing on direct rectal application of capsaicin in IBS patients [7], a regularized system for understanding its effects of oral capsaicin consumption on visceral hypersensitivity, in both IBS and non-IBS patients, has not been performed.

Spicy In Means Spicy Out: Capsaicin-Associated Anal Burn (CAAB) in Three US Metropolitan Populations, a New Proposed Classification System