You’ll think twice about holding in a sneeze next time after hearing this man’s awful story

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The next time you feel the need to sneeze, just let it out, even if you think it’s going to annoy people.

A 34-year-old man from Britain, a case published in the peer-revied medical journal MBJ reveals, pinched his nose and held in a sneeze, causing a pop in his throat that he later learned was a small hole being made.

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The case report, titled “Snap, crackle and pop: when sneezing leads to crackling in the neck,” which you can read in full online, explained that a small hole was created as a result of the “forceful” held in sneeze.

Here’s what the BMJ said in its summary of the case:

Spontaneous perforation of the pharynx is an unusual condition. Due to its non-specific presentation and general lack of awareness, diagnosis and intervention may be delayed resulting in potential complications. This case reports a rare spontaneous perforation of the pyriform sinus after a forceful sneeze, leading to cervical subcutaneous emphysema and pneumomediastinum.

While it is unusual, it’s still a real risk, as this case shows.

“When you sneeze, air comes out of you at about 150 miles per hour,” explained Dr. Anthony Aymat, director for ear, nose and throat services at London’s University Hospital Lewisham, who was not involved in the case. “If you retain all that pressure, it could do a lot of damage and you could end up like the Michelin Man with air trapped in your body.”

While examining the sneeze-averse patient, doctors in Leicester heard “crackling in the neck” down to his ribcage, a sign that air bubbles had seeped into his chest. Worried about infection and other possible complications, they admitted him to the hospital, gave him a feeding tube and administered antibiotics.

Dr. Zi Yang Jiang, a head and neck surgeon at University of Texas Health Science Center at Houston, said he sees one or two cases arising from repressed sneezes each year, making them an “exceedingly rare” occurrence.

Jiang said it was bizarre that a single sneeze could generate enough force to cause the kind of physical damage that usually results from trauma, such as a gunshot wound to the neck. A collapsed lung is among the problems that retaining the air from an imminent sneeze can cause, he said.

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“The whole point of sneezing is to get something out of your body, like viruses and bacteria, so if you stop that, those may end up in the wrong part of the body,” he said. Jiang said in most cases, the excess air is later absorbed by the body.

The English patient made a full recovery and was advised to avoid plugging his nose while sneezing in the future. Doctors recommend letting sneezes rip into a tissue instead.

“The safest thing to do — although it’s not socially acceptable — is just to sneeze loud,” Aymat said.

The Associated Press contributed to this report.

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