The relief one gets from sneezing is unparalleled. But people often find themselves in a kind of dilemma trying to control a sneeze in a social setting. The urge to curb is as natural as the action of sneezing itself — and has become even more widespread since the covid pandemic hit the world. This action, however, has potentially dangerous effects on the body. Constant, uncontrolled sneezing can be a sign of allergic rhinitis.
Understanding sneezing and why a sneeze shouldn’t be controlled is thus quite important.
Sneezing is a reflex action of the body in response to foreign particles invading the nose, with the aim of expelling out the irritants. But it can also be a sign of an underlying condition, the most common being allergic rhinitis. According to the US government’s National Library of Medicine, a diagnosis of allergic rhinitis is connected to a set of symptoms that affect the nose. One such symptom is constant sneezing, which appears when a person breathes in an allergen (a substance that triggers allergy).
Mechanism of sneezing
“There are small structures called turbinates inside the nose,” Dr Prashanth Reddy, chief ENT & endoscopic skull base surgeon at BGS Gleneagles Global Hospitals, Bengaluru, tells Happiest Health. “The lower turbinate of the front end of the nose is quite sensitive. So, when any irritant encounters it, it triggers a sneeze. This is a protective mechanism to prevent any kind of foreign body or irritant entering our airway.”
Dr Arunesh Kumar, senior consultant and HOD of pulmonology, Paras Hospitals, Gurugram, Haryana, says, “Sneezing in a way is a protective mechanism. The problem happens when your body’s reaction (sneezing) gets excessive. If you have extremely sensitive airways, your sneezing gets excessive and thus you sneeze more frequently.”
Why do some people sneeze constantly
Moushumi Pathak, a 47-year-old Bihu dancer from Guwahati, Assam, has been living with allergies for over 20 years now. Friends and family know her as someone who keeps on sneezing. She has tested positive for about 35 allergens to date, including dust mites and pollen. Her allergies peak during seasonal changes.
“These triggers make me sneeze repeatedly without a stop,” Pathak says. “There comes a point where I have swollen, watery eyes and become extremely fatigued. Hence, I always carry prescribed allergy tablets with me to put an end to my constant sneezing if it is triggered.”
Dr Kumar says sneezing once or twice is normal, but doing so repeatedly can be a sign of allergic rhinitis. “Consulting a doctor who can prescribe some anti-allergy medications is advised because excessive sneezing is tiring. It affects your quality of life,” he says.
Dr Reddy says, “When certain allergens irritate the nose, it signals the release of histamine. Its release will be triggered further, even though there is no actual irritant inside the nose, which is the reason people keep on constantly sneezing during an allergic reaction.”
Dr Inder Mohan Chugh, senior director of pulmonology and sleep medicine at Max Hospitals, Delhi, says that avoiding the source of allergic reactions is the best way to keep allergic rhinitis under control.
Why do some people sneeze louder than others
Dr Reddy says, “Well-built males usually tend to sneeze loudly due to large lung capacity, which is why their sneezing sound can be extremely loud. Thus, the volume depends on the lung capacity and built of a person.”
Dr Kumar says a person’s weight, body buildup, mouth and neck size determine the volume of their sneeze. “People also tend to develop their manner of sneezing since childhood. For instance, western societies encourage sneezing very quietly. But my advice would be to let sneezing be as natural as possible,” he says.
Why sneezing shouldn’t be controlled
According to an article published in The American Journal of Rhinology & Allergy in 2019, the typical amount of pressure generated during a sneeze is quite high. But when a person suppresses a sneeze, that pressure can increase by anywhere from five to 24 times more than it would normally. This is the primary reason a sneeze shouldn’t be suppressed. Men are thought to be more at risk of sneeze injuries due to the increased lung volume and pressure.
“If you try to control a sneeze that harmful irritant will still be inside your body, leading to different problems,” Dr Kumar says.
Dr Reddy says, “When you’re suppressing a sneeze, you’re pushing high-pressure air — which is intended to come out through the nose — to your ear, which will cause eardrum damage. It is never advised to control a sneeze.”
When sneezing should be controlled
When an organ or some tissue pushes through layers of weakening muscles or tissues in the abdomen, it is known as an abdominal hernia. In such a situation, the weakened abdominal muscles should not be strained further. Sneezing can cause stress in the abdomen since they [abdominal muscles] play a vital role in the action of sneezing.
“When you’re inhaling, you’ll notice that the abdomen becomes flat and big,” says Dr Reddy. “That’s because the diaphragm will push the abdomen down. But when you exhale to take out that volume of inhaled air, the diaphragm will get pushed up by the abdominal muscles to shrink the lung capacity and push that air out. So, when someone sneezes, the abdominal muscles along with the diaphragm will contract simultaneously to push that amount of air out rapidly.”
Dr Kumar says sneezing is a process which involves the muscles of the chest walls, neck, face and abdomen. “All these work in conjunction for sneezing to occur,” he says. “If somebody has abdominal hernia, it can be potentially harmful for your abdomen when one sneezes due to increased pressure in the abdomen. It is consistent sneezing that can make hernia worse.”
Sneezing is a natural defence mechanism of the body as a result of expelling foreign irritants. Repeated sneezing, however, might be a sign of allergic bronchitis. While experts advise that sneezing should never be controlled, in situations where the abdominal muscles should not be strained, like in the case of people with hernia, sneezing can turn out to be harmful.