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People suffering from peptic ulcers should generally avoid pepper of any kind, as pepper may cause dyspepsia. There are also cases of aspiration and subsequent death due to black pepper.
In Northern Iran, there reportedly is a higher esophageal cancer rate in women than men. The cancer is thought to be due to the food the women ingested when they were pregnant. During pregnancy, the women eat sour pomegranate seeds, black pepper and garlic, which irritate the esophagus.
Similarly in Tunisia, there is a high nasopharyngeal carcinoma risk associated with preserved spiced meat (quaddid), stew mixture of red and black pepper, garlic, oil, caraway and coriander and harissa (red pepper, olive oil, garlic, caraway, salt) taken with bread.
In a lab test, 10 mg of piperine injected into rats for 30 days caused decreases in testis weight, testicular testosterone, seminiferous tubular and Leydig cells, damage to seminiferous tubules, desquamation of spermatocytes and spermatids and increased serum gonadotropins. Piperine is known to also promote DNA damage and cytotoxicity.
(Source: HerbMed, http://www.herbmed.org)
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