What is Sjogren's Syndrome?
Sjogren's syndrome (Sjögren’s syndrome) is an autoimmune disorder. It happens when the immune system attacks healthy cells and tissues in the exocrine glands.
The exocrine glands produce body moisture. These include the tear, salivary, and sebaceous glands, among others.
The result of this is a decrease in body fluid production. Low saliva and tear production leads to dry mouth and dry eyes. Dryness also occurs in other parts of the body, such as the nose, skin, respiratory tract, and vaginal canal.
There is no cure for Sjogren's syndrome. Treatment mainly focuses on relieving symptoms.
Types of Sjogren’s Syndrome
There are two types of Sjogren's syndrome. It's referred to as
- Primary Sjogren's syndrome. When it occurs alone.
- Secondary Sjogren's syndrome. It occurs alongside other autoimmune conditions, such as lupus erythematosus (SLE) and rheumatoid arthritis.
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Sjogren's Syndrome (Dry Eyes & Dry Mouth)
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Symptoms of Sjogren's Syndrome
Symptoms of Sjogren's syndrome differ from one person to the other. You may experience one symptom or a combination of different symptoms.
Common Symptoms
The most common symptoms of Sjogren’s syndrome include:
- Dry eyes
- Dry mouth
- Joint and muscle pain or stiffness
The symptoms of dry eyes associated with Sjogren's syndrome include:
- Itchy or burning eyes
- Irritation in the eyes
- Persistent dryness due to low tear production
- Blurred vision
- A feeling of an object inside the eye
- Swollen eyelids
- Mucus discharge from the eyes
- Sensitivity to light (photophobia)
Other Symptoms
Sjogren’s syndrome may also cause other symptoms, such as:
- Sensitivity to light
- Dryness in the nose
- Abnormal sense of taste and smell
- Recurrent oral thrush (fungal infection)
- Increase in oral cavity infections
- Swollen salivary glands
- Blurred vision
- Dry cough and shortness of breath
- Headache
- Feeling exhausted
- Problems with concentration
- Vaginal dryness
- Pain and stiffness in the joints
- Heartburn
What Does a Sjogren’s Flare-Up Look Like?
Sjogren’s syndrome symptoms differ for everyone but often include red, dry eyes and dry skin.
What Causes Sjogren's Syndrome?
Sjogren’s syndrome is an autoimmune disease, which means it happens when the immune system attacks healthy cells.
Scientists don’t know exactly what causes the immune system to harm moisture-producing glands in a person with Sjogren’s syndrome. They believe genetic and environmental factors may be involved.10
Risk Factors for Sjogren’s Syndrome
People at increased risk for Sjogren’s syndrome include:
- People above 40 years are more likely to be affected
- Women are more prone to the disease
- Presence of other rheumatic conditions, such as rheumatoid arthritis
Who Gets Sjogren’s Syndrome?
Sjogren's syndrome affects all genders and age groups, but 90% of cases occur in women.1 This common autoimmune disease can occur at any age. However, most diagnoses are made in people aged 40 and above.
Potential Complications of Sjogren's Syndrome
Mucous membranes protect moist surfaces from infections. When the eyes or mouth runs dry, they become more susceptible to infectious bacteria and viruses.
The most significant complications of Sjogren's syndrome involve the mouth and eyes. They include:
- Dental cavities. Occur due to reduced saliva that fights most bacteria in your mouth.
- Yeast infections. People with Sjogren's syndrome are prone to oral yeast infection (oral thrush).
- Vision problems. Sensitivity to light and friction due to dry eyes can lead to corneal damage or blurry vision.
Complications that affect other body parts include:
- Organ inflammation. This may occur in the lungs, liver, and kidneys.
- Lymphoma. In rare cases, some people with Sjogren's syndrome may develop cancer of the lymph nodes (non-Hodgkin lymphoma.)
- Peripheral neuropathy. It's characterized by numbness or tingling in the hands and feet.
How is Sjogren's Syndrome Diagnosed?
Diagnosing Sjogren's syndrome is challenging since symptoms differ from one patient to the other. The signs may also appear similar to other conditions like chronic fatigue syndrome.
To begin, your doctor will do a physical exam and ask you a few questions to determine the following:
- Whether you have an itching or burning sensation in the eye
- Presence of stubborn cavities in your teeth
- Dryness in your mouth or lips
- Stiff or painful joints
Below are standard diagnostic procedures for Sjogren's syndrome:
- Labial gland (lip) biopsy. Your physician will cut a small part of the tissue or cell from your gland or inner lip. This sample is then examined for any sign of inflammation.
- Blood and urine tests. Your physician might request blood tests to check for blood cell count, Sjogren's antibodies, organ infections, and inflammatory diseases.
- Schirmer tear test. The physician may check your eyes using the Schirmer tear test to understand the level of dryness.
- Dye tests. Your doctor will administer eye drops to enable examination of the ocular surface.
- Imaging. Several imaging tests may be done to check if your salivary gland functions correctly. They include sialography and salivary scintigraphy.
- Health history. If you have any preexisting autoimmune condition combined with dry mouth and eyes, the doctor may conclude that you have secondary Sjögren's syndrome.
Treatment for Sjogren's Syndrome
Currently, there is no effective cure for Sjogren's syndrome. Treating Sjogren’s syndrome focuses on managing symptoms.
Your healthcare provider may recommend one or more of the following methods to treat eye symptoms of Sjogren’s syndrome:
Prescription Eye Drops
If your eyes are severely dry, your doctor will prescribe eye drops such as cyclosporine or lifitegrast to lubricate your eyes.
Artificial Tears
Artificial tears are useful in lubricating the eyes. You can get them over the counter, or your eye doctor can create customized artificial tears using your blood serum. However, custom artificial tears can be very expensive.
Punctal Plugs
These are tiny silicone plugs that block the tear ducts. This prevents tears from draining, which helps keep the eyes hydrated.
Surgery
If punctal plugs work well, your doctor may recommend surgery to close off the tear ducts permanently.
Other Treatments
Other ways to relieve symptoms include:
- Medications to increase tear and saliva production
- Treatments to relieve joint pain
- Dental care to reduce the risk of tooth decay
- Medications to treat fungal infections
What to Avoid if You Have Sjogren's Syndrome
According to the Sjogren's Syndrome Foundation, Sjogren's is associated with gastrointestinal problems such as irritable bowel syndrome and gastroesophageal reflux disease (GERD). Since this condition can’t be cured, therapy mostly focuses on managing symptoms.
Dietary choices are essential. Certain foods are recommended, while others are discouraged.
Foods to avoid include:
- Fried foods
- Saturated fats
- Refined grains
- Red meat
- Processed foods
- Allergenic foods such as peanuts, gluten, dairy, and poultry products
- Sugars and sweets
- Acidic foods (can worsen dry mouth sores)
- Artificial sweeteners and preservatives
- Refined oils
- Alcohol
Excessive vitamin consumption may result in poor absorption or metabolism of other nutrients. Don’t take vitamins or supplements unless you have spoken with your doctor first.
What to Eat if You Have Sjorgen’s Syndrome
Recommended foods include:
- Green leafy vegetables rich in vitamins and other minerals
- Minimal amounts of organic meat
- Whole grains
- Spices like ginger, garlic, and turmeric
- Fruits and vegetables
- Sugar-free gum
Summary
Sjogren's syndrome is an autoimmune disorder that causes dryness of the mouth and the eyes. Risk factors include older age, female sex, and other rheumatic diseases. It affects more women than men.
Although the real cause is unknown, research shows that genetics may play a role in developing this chronic disorder.
If you've been diagnosed with Sjogren's syndrome, maintain a healthy diet and consult your doctor in case of any severe symptoms.
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