By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S FRIEND HAS ACHOO, MAY BE DISQUALIFIED AS FIGHTER PILOT

Question: Yesterday I felt a sneeze coming on, but it just wouldn’t come. My nose tickled, my eyes watered, but I couldn’t sneeze. A friend told me to look at the sun, which I did, but it didn’t make me sneeze. She said it always made her sneeze. Why does looking at the sun make you sneeze?

Answer: Sneezing is a reflex that usually starts with an irritation of the lining, or mucous membrane, of the nose or throat and ends with a forceful burst of air through the nose and sometimes the mouth, too. This can be very bothersome but is generally not a sign of a serious problem. This complex reflex involves the abdominal muscles, the diaphragm, the chest, neck, face and eyelids.

Sneezing helps to remove irritants from the nasal and oral passages. Fortunately, sneezing is usually not a sign of a serious medical problem.

Allergies are probably the most common cause of sneezing. Depending on what you’re allergic to, you may have just a seasonal problem or yearlong misery. The good news is that there are many effective treatments for allergies.

Sneezing also can be an early symptom of a viral respiratory illness such as a cold or the flu.

In addition to allergies and viral respiratory illnesses, many other things can trigger a sneeze. Certain people, like your friend, sneeze when they are exposed to bright light, especially sunlight. This is called sun-photic sneezing. People with this problem often find relief by putting on sunglasses before they step outside. Some women sneeze when they pluck their eyebrows. Other people go through certain periods when they sneeze a lot for no apparent reason.

Sun-photic sneezing actually has an even more complicated name with a very clever acronym. It is sometimes called “Autosomal-dominant Compelling Helio-Ophthalmic Outburst.” The abbreviation of which is an approximation of the sound we make when we sneeze -- ACHOO! This propensity to sneeze in the presence of bright light is hereditary and affects about 20 percent of all humans. It is passed along genetically as an autosomal dominant trait, which means there is a 50 percent chance of inheriting this condition if only one parent is affected. Again, while not generally debilitating, it can be a risk factor for combat pilots. The exact mechanism of ACHOO is not clearly understood at present, but it is being investigated.

It is believed that the post-sneezing expression “God Bless You” started in the 6th century during the Bubonic plague epidemic. Sneezing was an early sign of the infection.

Sneezing is a very effective way of spreading germs and viruses. The average sneeze forces air and associated fluids out of the nose and mouth at about 75 miles per hour for a distance of up to 10 feet. This is why covering your mouth and nose when you sneeze is so important.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.