Sneezing – Causes, Diagnosis and treatment

Sneezing

Also called: Sternutation

Summary

A sneeze is a reflex response that involves the brain, the face, the throat, the chest and the abdominal muscles. It involves a sudden and forceful burst of air expelled from the nose and mouth. Particles expelled during sneezing can leave the body at speeds of up to 100 miles per hour.

Everyone sneezes in response to something at some time. It is one way the body removes annoying irritants or intruders from the nasal passages. For people with allergies, sneezing can be a frequent occurrence that requires treatment for relief.

Treatment options for sneezing depend on what is causing the response. These causes may include:

  • Irritation. A sneeze in response to an environmental irritant is treated by removing or avoiding the irritant.
  • Foreign object. Should a foreign object get lodged in the nose (occurs most often in children), the sneeze itself may solve the problem.
  • Infection. Sneezing related to a viral or bacterial infection is alleviated by treating the infection through either good hydration and rest, or medications.
  • Allergies. Sneezing related to allergies will be relieved by treating the underlying condition.

About sneezing

A sneeze is a reflex which causes a sudden, forceful burst of air through the nose and mouth. Sneezing is an involuntary response to many different physical stimuli or conditions.

The medical term for sneezing is sternutation. It is a way for the body to get rid of something irritating in the upper respiratory tract. It is a normal process and not usually a cause for concern. Many animals sneeze, including dogs and cats –  although, unlike humans, animals sneeze only through the nose and not the mouth.  

Sneezing is actually a complex physical process that involves the brain, nose, mouth and chest. It is a way for the body to get rid of a foreign object, such as particles of dirt stirred up in a cloud from a passing car. Other reasons to sneeze include exposure to bright light, which is a poorly understood reflex that appears to be an inherited trait. Individuals with this condition are called photic sneezers. Sneezing is also a symptom of allergies, colds, flu and many serious diseases.

The sneeze process begins when the nose encounters certain types of physical stimuli (e.g., dust, smoke, light). This stimulus informs a part of the brain called the sneeze center that something must be expelled from the nose and nasal cavity. The brain then sends a message to several different muscle groups. These muscles must all contract in the correct order for a sneeze to take place. The muscles and their order of contraction include:

  • Abdominal muscles
  • Chest muscles
  • Diaphragm (large muscles beneath the lungs)
  • Vocal cord muscles
  • Muscles in the back of the throat
  • Muscles in the eyelids (the eyes involuntarily close during a sneeze)

Sneezing may be more of a concern if accompanied by other symptoms. Hives, breathing difficulties, wheezing, shortness of breath and itchy eyes that occur with sneezing may be indicative of a medical condition that requires investigation. Patients are encouraged to discuss these symptoms with a physician.

Potential causes of sneezing

Sneezing is related to many different physical stimuli. Sneezing may be a reflux response to an environmental irritant, due to a cold, or a symptom of a medical condition that will require treatment.

Common causes of sneezing include:

  • Allergies (e.g., dust, pollen, mold, dander)
  • Foreign objects in the nose (occurs most often in children)
  • Nasal sprays
  • Environmental irritants (e.g., dust, smoke)
  • Poor indoor air quality
  • Bright light
  • Pregnancy
  • Plucking the eyebrows
  • Viral infections (e.g., colds, flu)
  • Chemicals

Related allergies and conditions

Although sneezing is not usually a sign of a serious problem, there are a number of medical conditions that include sneezing as a major symptom. These include:

  • Allergies. An overreaction of the body to a harmless substance leading to symptoms such as itchy eyes, runny nose and sneezing. In some cases, the reaction is more extreme, resulting in hives, eczema (skin inflammation) or breathing difficulties.
  • Colds/flu. Contagious respiratory illness caused by viruses. Cold and flu symptoms are similar to allergy symptoms. These conditions trigger sneezing by causing swelling and irritation in the nose. Contrary to popular belief, cold viruses are very rarely spread by airborne particles released during a sneeze.
  • Whooping cough. A contagious disease in which a dry cough worsens over time, producing a “whooping” sound. Other symptoms include fever, runny nose, sneezing and possible vomiting. A vaccine is available.
  • Other serious disease. There are several serious diseases whose symptoms include sneezing. These diseases include tuberculosis, mononucleosis and severe acute respiratory syndrome (SARS).

Diagnosis and treatment of sneezing

Many types of sneezing are healthy responses that do not require a physician (e.g., an encounter with a cloud of black pepper). However, sneezing that occurs repeatedly over a period of time may be associated with a medical condition that requires treatment. 

A physician can use several methods to accurately diagnose the reason for repeated episodes of sneezing. An examination of the lungs, heart and upper-airway passages can often reveal clues. A history of any breathing problems is also likely to shed light on the nature of the disorder. The physician will develop a detailed medical history and complete a physical examination to diagnose any underlying medical conditions that are the source of the sneezing.

The kinds of issues a physician may inquire about to document sneezing patterns include:

  • Seasons that sneezing occurs (if any)
  • When the sneezing began
  • How long sneezing episodes last
  • Any personal or family history of allergies
  • Any other symptoms
  • The effectiveness of any medications taken to relieve symptoms

If sneezing is the result of an allergy, treating the underlying condition may help to alleviate the sneezing. The first step is identifying the allergen that is triggering the sneezing and other symptoms. Once the allergen is identified, treatment may include avoidance and medications such as antihistamines, nasal steroid sprays and allergy shots.

When sneezing is the result of exposure to an environmental irritant, removing the irritant will alleviate the sneezing. For indoor air quality related sneezing, improving the air will provide relief.

Colds and flu that are accompanied by sneezing may be contagious. Even though sneezing is responsible for far less germ passage than most people think, patients should make sure to cover their nose and mouth while sneezing to avoid contaminating others. Sneezing related to colds and flu is best treated with good nutrition and rest. It will usually go away on its own without medical intervention.

Questions for your doctor

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to sneezing:

  1. What may be causing me to sneeze so much? Do you suspect an allergy?
  2. What methods will you use to determine the cause of my sneezing? Will I require an allergy test?
  3. Are there any risks associated with sneezing?
  4. What treatments are available to me?
  5. Should I expect sneezing to be worse at certain times of year or will it occur consistently year-round?
  6. How can I avoid the allergen that is triggering my sneezing?
  7. Under what circumstances should I seek a physician’s attention for sneezing?
  8. How can I improve the indoor air quality in my home?
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