Sjogren's Syndrome

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What is Sjögren’s Syndrome?

Sjögren’s syndrome is a health condition where a person’s immune system attacks certain parts of the body. It most often attacks the tear and saliva glands. This makes the glands stop working, and causes dry eyes and mouth. It can also cause dryness of the throat, skin, inside of the nose, and the vagina. It can also include symptoms of rheumatoid arthritis, such as pain and inflammation in joints. In some cases, it can also harm organs in the body such as the kidneys, liver, lungs, pancreas, and brain. Sjögren’s is most common in women over age 40.

Symptoms of Sjögren’s syndrome

Signs and symptoms can be mild to severe. They can get better or worse over time, or may go away for a period of time and then come back. Signs and symptoms can include:

  • Dry mouth

  • Dry throat and lips

  • Oral health problems such as cavities and infections

  • Hoarseness of the voice

  • Chronic dry cough

  • Difficulty swallowing

  • Swelling of salivary glands in the face and neck

  • Heartburn

  • Painful, burning, or gritty-feeling eyes

  • Blurred vision

  • Eye infections

  • Dry nose

  • Nose bleeds

  • Sinus infections

  • Vaginal dryness

  • Dry skin

  • Joint and muscle pain

  • Fatigue

  • Trouble concentrating

Cases of Sjögren’s that are more severe can also include signs and symptoms such as:

  • Red rash from inflammation of blood vessels (vasculitis)

  • Numbness and tingling in the hands or feet

  • Inflammation of the liver (hepatitis)

  • Inflammation of the pancreas (pancreatitis)

  • Lung infections

Causes of Sjögren’s syndrome

Your immune system’s job is to fight off germs that can cause you harm. But with an immune illness such as Sjögren’s syndrome, the immune system attacks your own body. The exact cause of Sjögren’s is not yet known, but scientific researchers think it may be caused by genes and exposure to a certain virus or bacteria. Research is still being done to find out more.

Diagnosing Sjögren’s syndrome 

Sjögren’s syndrome can be difficult to diagnose. Its signs and symptoms can be similar to those of other conditions, or they may be mild and not seem like part of a larger disease. Your health care provider will give you a physical exam and ask you questions about your symptoms. Make sure to tell him or her about all symptoms you have had. You may also have tests such as:

  • Blood tests. These look for certain chemicals in the blood that can show how active your body's immune system is.

  • Eye tests. Your tear production may be measured. You may also be given special eye drops that show dry patches on the eyes.

  • Mouth tests. The function of your saliva gland and your saliva flow may be measured. You may also have a small piece of a salivary gland removed for testing (biopsy).

  • Urine test.

  • Chest X-ray.

Treating Sjögren’s syndrome

There is no cure for Sjögren’s, but its signs and symptoms can be treated. Your treatment depends on what your signs and symptoms are. Treatment can include:

  • Medication. There are different kinds of medications that can treat joint and muscle pain, reduce inflammation, help you make more saliva, and cause the immune system to not work as much.

  • Eye drops, gel, or ointment. These can treat dryness of the eye.

  • Lip balm or ointment. This can help soothe dry lips.

  • Sugar-free gum or candy. These can help your mouth make more saliva.

  • Artificial saliva. Your health care provider can prescribe a rinse or spray to help keep your mouth moist.

  • Saline nasal spray. This can help relieve dryness in the nose.

  • Antacids. These can treat symptoms of heartburn.

  • Surgery. In some cases, this can be done to close the tear ducts that drain tears from the eyes.

Living with Sjögren’s Syndrome

If you have Sjögren’s, there will be certain things you will need to pay attention to in order to stay healthy.

Good oral hygiene

If you have dry mouth, that means you have less saliva. Saliva helps prevents infection, gum disease, and tooth decay. Because saliva helps keep a mouth healthy, you’ll need to take extra care to prevent problems. You’ll need to take good care of your teeth, including brushing and flossing regularly. You also may need to see your dentist more often for checkups and cleanings. He or she can help you prevent problems, and spot problems such as tooth decay early. You’re also more at risk for infections in the mouth from yeast, fungus, or bacteria. Tell your dentist if you have white patches or sore spots in your mouth.

You may also need to reduce your use of medicines that can make mouth dryness worse, such as medicines for allergies, high blood pressure, depression, and more. Ask your health care provider about your medications.

Avoid certain food and drink

You may need to make some changes to what you eat and drink. It may help to avoid foods that are salty, spicy, or acidic – these can dry and irritate your mouth. You may also want to avoid drinking alcohol, which can also dry your mouth. You may want to choose soft and smooth foods, or make foods moist with sauces or broth. If you use mints or hard candy to stimulate saliva, enjoy the sugar-free variety to avoid an increase in dental cavities.

Check your eyes

If you have eye symptoms, you’ll also need to see your eye doctor regularly. He or she can check for eye infections, and look for signs of damage to the cornea of your eye.

Look out for infection

If your Sjögren’s symptoms are severe and you take medication to suppress your immune system, that means your body will be less able to fight off infections. Your health care provider will give you advice about staying healthy.

People with Sjögren’s also have a higher risk of cancer of the lymph glands, also known as lymphoma. Make sure to see your health care provider regularly to check for swollen lymph glands.

For many people, Sjögren’s syndrome can be managed with treatment and doesn’t cause severe health problems. Work with your health care provider to find the right treatment for you.

 

Sources:

What Is Sjögren's Syndrome? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome/sjogrens_syndrome_ff.asp Accessed 2013.

NINDS Sjögren's Syndrome Information Page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/sjogrens/sjogrens.htm Accessed 2013.

Medications may relieve some Sjögren syndrome symptoms. American Dental Association Center for Evidence-Based Dentistry. http://ebd.ada.org/PLS/PlainLanguageSummaryDetail.aspx?plsId=fb11536b-e578-45ca-b173-11923a1f8cde Accessed 2013.

Sjögren's Syndrome. American College of Rheumatology. http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Sj%C3%B6gren_s_Syndrome/Accessed 2013.

Symptoms. Sjogrens Syndrome Foundation. http://www.sjogrens.org/home/about-sjogrens-syndrome/symptoms Accessed 2013.

Diagnosis. Sjogrens Syndrome Foundation. http://www.sjogrens.org/home/about-sjogrens-syndrome/diagnosisAccessed 2013.

Treatments. Sjogrens Syndrome Foundation. http://www.sjogrens.org/home/about-sjogrens-syndrome/treatments Accessed 2013. 

Diet & Food Tips. Sjogrens Syndrome Foundation. http://www.sjogrens.org/home/about-sjogrens-syndrome/living-with-sjogrens/diet-a-food-tips Accessed 2013.

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