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Sometimes she'll taste it but I don't.. She says it burns her mouth. I've looked into her medications, which are few. I'm starting to think it might be related to stress/anxiety but I dont want to pigeon hole her with that assumption. Doctors have been no help.

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I get the pepper sensation from foods that have been treated with sulfite preservatives, usually bagged lettuce or pre-cut fruit pieces. I am allergic to sulfites and keep Benadryl handy if I eat at a restaurant buffet.
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Do a taste test with foods that absolutely have no pepper. Start with a plain food..vanilla yogurt , butter etc. see what happens..if she is tasting pepper then progress with medical help. Her dr will probably suggest this, so now you'll be ahead of the game.
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There is also a thing called "burning mouth syndrome" where people perceive their mouth (usually the tongue) to be burning. I have that at times. It's an autoimmune thing related to oral lichen planus. So it's possible your mom is having some kind of reaction that is unrelated to pepper but that she relates to the idea that there's pepper in the food. There's no real cure, other than steroids, which have their own set of issues.
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THRUSH .. trust me , im an idiot ..
marys magic mouthwash is a specially formulated medication ( prescription ) to kill thrush and even topically curtail the discomfort of it in the short term ..
aunt -- dementia -- compromised immune system --ongoing thrush -- tongue burning like fire -- marys swill helps immensely -- not cheap -- 80 friggin bucks -- worth it .. end of story ..
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I am allergic to black pepper. Even a tiny amount will burn my mouth and cause my IBS problems to go crazy. Unless you have prepared the food yourself do not assume there is no pepper in the food. I have been in restaurants where there was literally nothing on the menu I could eat except for a roll or dessert. They put pepper in everything and you can't always taste it. This was an allergy I developed late in life. It is possible your mother has developed the same problem.
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It could be and allergy also. My mother cannot have pepper in her food either it make her alots. She has problem throat and lungs. So we avoid anything that has pepper on the ingredients. So read label when buying and also season of any type.
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Then take her at her word and leave all pepper out of her food. Her taste buds have changed and what may not taste like pepper to you, doesn't mean it doesn't burn her tongue. I have a sensitive tongue and my husband can eat all things spicy. I have rarely heard of a medication that has pepper taste as a side effect. Try getting Biotene mouthwaste and toothpaste to lubricate her mouth and see if that helps.
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Check to be sure she does not have a sore throat. I have allergies, when they flare I sleep with my mouth open (apparently, my cat doesn't tell me). When my throat is dry and sore, stuff I eat burns a bit. And yes, test out foods to see her response, and write it down.
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Sorry, I meant to say "mouthwash". Haven't eaten breakfast yet!
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This could be an olfactory hallucination, triggered by food??
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