We've all been there: you feel a sneeze tickling and instead of letting it out, you hold it in. Whether it's flu season or allergy season, sneezing happens and there's no reason to be ashamed of it. By washing your hands frequently and maintaining healthy habits, a mere sneeze shouldn't do much harm. It's what happens when you hold in a sneeze, however, that can lead to serious damage. Why? Well because sneezing blasts mucus and air from the nose and mouth at over 100 miles per hour. And all of that energy needs to go somewhere.
A case study published Monday in the medical journal BMJ Case Reports focused on the case of a 34-year-old man in Great Britain who learned his lesson in a quite painful way. A healthy and "previously fit" man pinched his nose and kept his mouth shut during a sneeze that the study labelled as "forceful." Soon after, he described a "popping sensation in his neck and some bilateral neck swelling" and gradually, his neck swelling increased, his throat hurt, and his voice changed. A trip to the emergency room was necessary. As the case report author Dr. Wanding Yang told CNN,
"This 34-year-old chap said he was always trying to hold his sneeze because he thinks it is very unhygienic to sneeze into the atmosphere or into someone's face. That means he's been holding his sneezes for the last 30 years or so, but this time it was different."
By holding in a sneeze, the case reports, this healthy man in good physical condition actually blew a small hole in his throat, characterized by "streaks of air in the retropharyngeal region and extensive surgical emphysema in the neck anterior to the trachea."
After being given antibiotics and being fed through a tube that was removed after seven days, his symptoms improved. As Dr. Adam M. Klein said of the patient in the study to CNN, "It is a rare injury that we would more likely see with trauma, like if someone were to be in a car accident or was injured with a gunshot or knife, or if they swallowed something sharp."
While there was no permanent damage to the patient, let this be a lesson that holding in a sneeze can cause serious injury. Apart from the numerous complications, including air bubbles, vomiting, a ruptured ear drum, and even ear infections from unreleased mucus, a stifled sneeze could put you in an expensive medical situation.