This culinary barbarity from Cincinnati, Ohio is really a hoked-up spaghetti sauce that consists of a faux weak chili flavored with spices such as chocolate, cinnamon, allspice, and possibly Worcestershire.
This goop is spooned on pasta (of all things!) and topped off with ingredients such as chopped onions, shredded Cheddar cheese, beans, and crushed oyster crackers. Cincinnatians who specify Five-Way Chili get the works: all of that.
A trip to Ohio would not be complete without sampling some Cincinnati chili, and enjoying the dribbling diarrhea that it both resembles and may result from it.