If we think about the kind of accident that would cause a person’s intestines to burst out of their body, we might imagine some kind of horrible stabbing or a gruesome car accident. You’d probably never imagine that something as common and harmless as a sneeze could cause this type of gruesome injury, but that’s exactly what happened to a Florida man in early June.
The patient had recently undergone abdominal surgery and was suffering from wound dehiscence. That is, his surgical incision was not healing properly. While eating breakfast, he sneezed and started coughing. He noticed pain and a damp sensation in his lower abdomen, and immediately discovered that several loops of intestine had burst through the unhealed wound. The man was rushed to the hospital, where his intestines were placed back inside his abdomen.
Close your eyes and contract your chest
Normally, sneezing is a protective mechanism that prevents dust, bacteria and viruses from entering our respiratory system. The process is controlled by the so-called “sneeze center”, located in the medulla oblongata, between the brain and the spinal cord, which directs autonomic functions, including breathing. It is activated by the presence of irritants in the lining of the nose and airways.
The response is to close your eyes, throat, and mouth while contracting your chest muscles, compressing your lungs and pushing air out of your respiratory system. In this way, whatever triggered the response “leaves” from the body at an impressive speed: up to 15.9 meters per second (56 km/h) in some cases.
But despite the benefits of a good sneeze, it can sometimes carry a greater risk of injury than many realize.
For example, a violent sneeze can cause a lung hernia through the intercostal muscles between the ribs, usually at a weak point. This is usually a consequence of morbid obesity, chronic obstructive pulmonary disease, diabetes or smoking.
There are also cases of sneezing causing the delicate tissues of the lungs to tear. This occurs when higher pressure air from deep within the lungs escapes into the space between the chest and the lung, causing this air to compress the lung on one or both sides of the chest.
The lungs aren’t the only thing that can tear. There are cases of people tearing the delicate lining of the brain when sneezing, causing a subarachnoid hemorrhage (a type of stroke) that can be fatal if not diagnosed and treated in time.
Even if this delicate lining is not torn, a sneeze can affect the brain, and there are reports of people experiencing weakness on one side of the body or visual disturbances after a sneeze.
Back injuries, broken bones…
Sneezing raises blood pressure, which can cause other serious injuries to blood vessels. There are cases of aortic dissection due to sneezing, in which the force of the sneeze tears the layers of the aorta (the main artery that carries oxygenated blood throughout the body). If left untreated, it has a 50% mortality rate within 48 hours of its occurrence.
Although it is quite common to injure your back when sneezing, it is not the only musculoskeletal injury that can be triggered by a sneeze: there are case reports of people who have fractured the bones around the eye. This type of fracture, called a sneeze fracture, is usually caused by blunt force trauma, often from a golf, tennis, or baseball hit to the eye. The ear bones can also fracture after a sneeze, which can cause hearing loss. Dental implants have even been known to move to other parts of the face due to a loud sneeze.
The increase in pressure caused by sneezing can cause fluid to leak from the body, particularly urine from the bladder. This usually occurs in people with weak pelvic floor muscles, usually due to pregnancy, childbirth, obesity, menopause, and trauma or nerve injuries.
Don’t hold on
Given all the potential injuries a sneeze can cause, you may think it’s best to suck it up.
But even that is not certain. In 2023, a Scot held back a sneeze by closing his mouth and covering his nose. The result was that his trachea was torn. By closing your airway, you allowed the pressure generated by the sneeze to build up in the respiratory system, which can sometimes be up to 20 times the pressure normally seen in the respiratory system. But this energy has to go somewhere, so it is normally absorbed by the tissues.
Others have broken facial bones holding back sneezes, damaged their larynx (voice box) and torn the tissues that protect their lungs.
Fortunately, there is one injury that cannot possibly cause a sneeze. Have you ever been told that if you sneeze with your eyes open, they will pop out? Well, it’s just a tall tale: the eyes are held in place thanks to muscles and a nerve that holds them. Without forgetting that the respiratory tract has no connection with the eyeballs or eye sockets.
Our body is well adapted to sneezing, so you probably don’t have to worry about sustaining any injuries. Many of the damages described only occur in very rare circumstances. Although if you’re someone like Donna Griffiths (who has the longest sneezing fit on record, lasting 976 days) or Yi Yang (who has the loudest sneeze on record, at 176 decibels, the equivalent of a rocket taking flight), the risk that sneezing will cause problems is greater.
**Article originally published in ‘The Conversation’**
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