"Don't hold it in"... Forcing yourself to stifle a sneeze can lead to something terrible [Health Talk]

[Financial News] When you suddenly have to sneeze in a quiet setting, it can feel awkward. So some people pinch their nose or clamp their mouth shut to hold it in. However, experts warn that forcibly suppressing a sneeze can cause serious physical damage.
Teresa Larkin, an associate professor in the School of Medicine at the University of Wollongong in Australia, said, "If you block your mouth or nose when you sneeze, the pressure in your airway becomes 5 to 20 times higher than during a normal sneeze, and that pressure is transmitted to other parts of the body," adding, "This behavior can damage the eyes, ears, and blood vessels."
Blocking your nose and mouth when you sneeze can cause a rupture near the esophagus. According to a case report in the British Medical Journal (BMJ), in 2018 a 34-year-old man was diagnosed with spontaneous esophageal rupture after a perforation developed in the pharynx, the area between the mouth and esophagus, while he was trying to hold in a sneeze. He had tightly pinched his nose and kept his mouth closed to suppress the sneeze, and then felt something explode near his neck.
During a sneeze, the pressure in the upper airway is usually around 1–2 kPa (kilopascals), but if you close both your mouth and nose, that pressure can increase by 5 to 20 times. This elevated pressure can tear the tissues of the pharynx and create a perforation.
The pressure that builds up when you suppress a sneeze can also rupture the tiny blood vessels in the eyes and nose. When these capillaries burst, superficial damage can appear on the face, making it red and blotchy. You may also see red spots in the eyes or experience a small nosebleed, and in severe cases the eardrum can rupture.
Although rare, pressure building up in the face from holding in a sneeze can even trigger a cerebral aneurysm. This occurs when a weakened blood vessel balloons out, and if a vessel in the brain bursts, bleeding develops around the brain inside the skull and can be life-threatening. A ruptured brain vessel can cause extensive brain damage, and 3 out of 5 patients die within two weeks. The risk is higher if you already have vascular disease, high blood pressure, or lung disease.
Sneezing helps expel harmful substances from the nose, such as bacteria. In particular, if you have a cold or the flu and you hold back sneezes, you can develop an ear infection. Suppressing a sneeze can force air carrying bacteria or infected mucus back into the middle ear, leading to infection.
Therefore, when you feel a sneeze coming on, it is best to let it out freely while covering your mouth and nose with a tissue, handkerchief, or the inside of your elbow to prevent droplets from spreading. If you are in a quiet place and worried about the noise, do not completely block your mouth and nose; instead, lightly cover them with your elbow or a tissue so that air still has a way to escape. Holding back a sneeze once or twice is usually not a big problem, but you should avoid habitually and forcefully suppressing sneezes.
moon@fnnews.com Moon Young-jin Reporter