There’s a lot of old-school pseudo-medicine that says holding in a sneeze could be bad for your health: Sneezing helps get the devil out, so the theory goes, so your bodily function is actually a vital component of exorcism or something.

But according to a new case report published in the British Journal of Medicine and seen by Gizmodo, there’s a very real reason to let it out. One 34-year-old man who tried to hold in a sneeze by plugging his mouth and nose ended up with major damage to his throat, a feeding tube down his neck, and a week-long hospital visit.

According to the report, the man tried to hold in a sneeze by closing his mouth and nose. Immediately after, he felt a popping sensation in his throat, lost his voice, and was unable to swallow normally. When he was seen by doctors at his local Accident and Emergency room, they found that closing off his mouth and nose has caused the force of the sneeze to puncture his pharynx, the upper section of his throat. In addition, doctors found a crackling sound caused by air bubbles that had found their way into the soft tissue of his neck, via the hole in his pharynx.

The man was admitted to hospital, fitted with a feeding tube to bypass the hole in his throat, and given a course of antibiotics to prevent infection. After a week-long stay in the hospital, the feeding tube was removed, and a follow-up inspection months later concluded that he had made a full recovery.

The reason the case merited a write-up in the BMJ is because it’s unusual — holding in a sneeze doesn’t normally cause you to puncture your throat, else I’m sure the danger would be much more widely known. But rare or not, the case still gives a very compelling reason to only cover your nose when you sneeze, not plug it completely.