When you imagine the kind of accident where a person’s intestines explode out of their body, you might think of a gruesome stabbing or a horrific car crash. You probably wouldn’t imagine that something as mundane and innocuous as a sneeze would cause this kind of horrific injury, but that’s exactly what happened to a Florida man earlier this month.
The man had recently undergone abdominal surgery and was suffering from wound dehiscence, with his surgical scar not healing properly. While eating breakfast, the man first sneezed and then began to cough. He felt pain and a wet feeling in his lower abdomen, but discovered that several loops of his intestine had burst through his unhealed wound.
The man was rushed to hospital for emergency surgery, during which his intestines were placed back into his abdomen.
Sneezing is normally a protective mechanism that keeps potentially harmful things, such as dust, bacteria and viruses, out of our respiratory system. The process is controlled by the so-called “sneeze center” in the medulla of the brain (which controls autonomic functions, including breathing). It is activated by the presence of irritants in the lining of the nose and airways, which send impulses to the center.
The response is a closing of your eyes, throat, and mouth as your chest muscles contract, compressing your lungs and pushing air out of your respiratory system. This forces whatever caused the response to “exit” from your system at an impressive speed, in some cases up to 15.9 m/s (35 mph).
But despite the benefits of a good sneeze, it can sometimes carry a greater risk of injury than most people realize.
For example, a violent sneeze can cause the lungs to bulge through the intercostal muscles between the ribs, usually at a weak point. This is most often the result of morbid obesity, chronic obstructive pulmonary disease, diabetes, or smoking.
There are also known cases of sneezing tearing the delicate tissues of the lungs. This occurs when air with higher pressure escapes deep in the lungs 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 rupture. There are reports of people rupturing the delicate lining of their brain through sneezing, leading to a subarachnoid hemorrhage (a type of stroke) that can be fatal if not diagnosed and treated promptly.
Even if you don't tear this delicate mucous membrane, a sneeze can still affect the brain. There are reports of people experiencing weakness on one side of the body or vision problems after a sneeze.
Sneezing increases blood pressure, which can lead to other serious injuries to the blood vessels. There have been cases of aortic dissection from sneezing, where the force of a sneeze tears the layers of the aorta (the main artery that carries oxygenated blood throughout the body) and causes blood to burst between the layers. If untreated, mortality within 48 hours of the event is 50 percent.
While it’s fairly common to injure your back while sneezing, it’s not the only musculoskeletal injury that can happen. There are case reports of people breaking the bones around their eye from sneezing. This type of fracture, called a blowout fracture, is usually caused by blunt force trauma, often from a golf, tennis, or baseball game to the eye.
The tiny bones of the ear can break after a sneeze, causing hearing loss. Dental implants have been known to dislodge themselves in other areas of the face from a forceful sneeze.
The increased pressure caused by sneezing can cause fluid to escape from the body, especially urine from the bladder. This is most commonly seen in people with weak pelvic floor muscles, usually caused by pregnancy, childbirth, obesity, menopause, and physical trauma or nerve damage.
Don't hold it
Given the potential injury a sneeze can cause, you might think it's better to hold in your sneeze.
But even that isn’t safe to do. In 2023, a Scottish man held in a sneeze by closing his mouth and holding his nose. This resulted in the rupture of his windpipe. By closing off his airway, the pressure generated by the sneeze was able to build up in the respiratory tract, sometimes as much as 20 times the pressure normally seen in the respiratory tract. But this energy has to go somewhere, so it is usually absorbed by the tissues.
Others have broken bones in their faces from holding in a sneeze, damaged larynxes, and torn chest tissue that protects their lungs.
Fortunately, there is one injury that cannot possibly be caused by a sneeze. Have you ever been told that if you sneeze with your eyes open, they will pop out? Fortunately, that is just a myth. This is because your eyes are held in place by muscles and a nerve that keeps them in place. Not to mention that the airways in our respiratory system have no connection to your eyeballs or eye sockets.
Our bodies are well adapted for sneezing, so you probably don’t have to worry about injury since much of this damage only occurs in very rare cases. But if you’re someone like Donna Griffiths (who has the longest recorded sneeze, which lasted 976 days of nose-clearing) or Yi Yang (who has the loudest recorded sneeze at 176 decibels, the equivalent of a rocket taking off), you may be at greater risk for damage.
Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University. This article is republished from The Conversation under a Creative Commons license. Read the original article.
