Sjögren's (pronounced SHO'-grenz) syndrome is a chronic autoimmune disease in which the body’s immune system attacks moisture-producing glands, such as those that produce saliva and tears. This is why dry eyes and mouth are two of the most common symptoms of Sjögren's syndrome. The disease also affects other areas of the body, including the kidneys, blood vessels, joints, and the brain.
Signs and Symptoms of Sjögren's Syndrome
- Dry eyes
- Burning or stinging in the eyes
- Blurry vision
- Sensation that foreign particles or something gritty is in the eyes
- Sensitivity to light
- Blephartis (inflammation in the eyelids)
Mouth, Throat, and Nose Symptoms
- Dry mouth (which may include thick and stringy saliva)
- Swollen salivary glands
- Mouth sores
- Dental issues, such as cavities and gum inflammation
- Altered sense of taste and smell
- Dry nasal passages or sinusitis
- Dry or burning throat
- Difficulty swallowing
- Hoarseness, difficulty speaking
- Dry cough
- Excessive fatigue
- Joint pain or swelling
- Muscle aches
- Numbness or tingling in the hands or feet
- Dry skin
- Cognitive issues, such as memory loss or brain fog
- Gastrointestinal problems, such as nausea or heartburn
- Respiratory issues, such as shortness of breath, recurrent bronchitis, pneumonia
- Vaginal dryness
- Painful urination
How Is Sjögren's Syndrome Diagnosed?
- Blood Tests These look for specific antibodies common in Sjögren's syndrome as well as evidence of other autoimmune disorders, such as lupus and rheumatoid arthritis.
- Biopsy Your doctor may remove tissue or cells from your salivary glands in your lip to send to a lab to check for signs of inflammation.
- Imaging Tests These may include an ultrasound or magnetic resonance imagine (MRI), on the salivary gland.
- Sialometry This noninvasive test measures the amount of saliva you can produce over a set period of time.
- Eye Tests These tests will typically be performed by an ophthalmologist and may include a Schirmer's test, which measures the amount of tears your eyes make over a certain period of time, and a dye test that can help your doctor see how dryness has affected your cornea and other parts of your eye.
Prognosis of Sjögren's Syndrome
For people whose Sjögren's syndrome is moderate to severe, symptoms such as eye discomfort, recurrent mouth infections, difficulty swallowing, joint pain, and debilitating fatigue can all have a negative impact on quality of life.
Treatment and Medication Options for Sjögren's Syndrome
Your doctor may suggest the following strategies and treatments:
Related: 8 Do-It-Yourself Ways to Manage Dry Eye
If you're experiencing gastrointestinal symptoms, talk to your rheumatologist and a registered dietitian to identify which foods you should avoid and what you should include in your diet to make sure you get the nutrients you need. Sometimes this requires keeping a so-called food diary, in which you record what you eat and try to correlate that with your symptoms.
- Mild Pain Relievers for Muscle and Joint Pain These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.
- Cholinergic Agonists Your doctor may prescribe these medications, which help to stimulate secretions in the body, to help create more tears and saliva.
- Vaginal Dryness Remedies Doctors may recommend over-the-counter vaginal moisturizers or prescription estrogen (in cream, ring, or tablet form) for those who may be experiencing vaginal dryness.
- Steroids, Such as Predisone, to Treat Flares of Symptoms Like Joint Pain or Rashes While prednisone and other steroids are effective at decreasing inflammation, they have side effects — such as weight gain and high blood pressure and osteoporosis — associated with higher doses and long-term use.
- Immunosuppressant Drugs for Joint Pain. As their name suggests, these medications suppress an overactive immune system. Your doctor may initially prescribe hydroxychloroquine; methotrexate may be considered next. In more severe cases of Sjögren's, in which organs are affected, doctors may prescribe more powerful immunosuppressants, such as cyclophosphamide and rituximab.
Alternative and Complementary Therapies
- Acupuncture for Dry Eye A review of studies published in May 2018 in BMC Complementary Medicine and Therapies found that acupuncture was more effective than artificial tears in treating dry eye syndrome.
- Paraffin Bath Applying moist heat to your hands and wrists in the morning by immersing them in warm wax may help with stiffness, according to the Johns Hopkins Sjögren's Center.
- Gentle Exercises The Johns Hopkins Sjögren's Center also notes the benefits of tai chi, yoga, and dancing to strengthen muscles and help maintain range of motion.
- Nutritional Supplements Some research, such as study published in November 2016 in the journal Cornea, has suggested that omega-3 supplements may help improve symptoms associated with dry eye.
Prevention of Sjogren's Syndrome
There is no known way to prevent Sjögren's syndrome, but there are treatments and measures you can take to alleviate your symptoms such as dry eyes and mouth and joint pain.
Research and Statistics: Who Has Sjögren's Syndrome?
Resources We Love
This national nonprofit foundation focuses on increasing education, awareness, and research about this condition and providing support and information to people with Sjogren's and their loved ones.
National Institute of Dental and Craniofacial Research
Where can you go for info on the latest research on Sjögren's syndrome? How can you find a clinical trial? This National Institutes of Health site is an excellent hub of information and reliable resources for Sjögren's syndrome.
UNC School of Medicine's Autoimmune Disease Podcast
This 12-part series on autoimmune diseases includes an episode on Sjogren's Syndrome. Beth Jonas, MD, an associate professor of medicine in the division of rheumatology, allergy, and immunology at UNC School of Medicine, discusses the disease and how to manage it.
Editorial Sources and Fact-Checking
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- Epitropoulos A, Donnenfeld E, Shah Z, et al. Effect of Oral Re-Esterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea. September 2016.
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