Sjögren’s syndrome is more common in older females, though it can still potentially affect people of any age or gender. It is an autoimmune condition that is essentially a complication related to another autoimmune disease. For example, it’s a somewhat common complication of lupus and rheumatoid arthritis.
It’s estimated that between 400,000 to 3.1 million adults have Sjögren’s syndrome or will develop it at some point in life. Symptoms vary but most people with Sjögren’s syndrome experience problems with chronic dry eye, dry mouth, increased risk of dental diseases, and related infections. It’s also worth noting that individuals with Sjögren’s syndrome are also at increased risk for certain types of cancer, particularly lymphoma.
Sjögren’s syndrome is essentially a chronic inflammatory disease that can affect different parts of the body at the same time. Though the tear and saliva glands tend to be the most common, which leads to chronic problems with dry eye and dry mouth.
Many people with Sjögren’s syndrome complain of eye irritation, or a gritty feeling, or painful burning in the eyes. Individuals with severe dry mouth problems may find it difficult to eat dry foods and sometimes swelling of the glands around the face and neck. Many people with Sjögren’s syndrome will also experience periodic dryness in the nasal passages, throat, vagina, and skin. Some also complain of frequent problems with acid reflux.
There Are Two Different Types Of Sjögren’s Syndrome
There are technically two different variations of Sjögren’s syndrome. The severity of symptoms will typically influence the treatment plan.
Primary” Sjögren’s Syndrome
Indicated that the symptoms occur when no other rheumatic disease autoimmune disorder or chronic inflammation present.
Secondary” Sjögren’s Syndrome
Occurs in conjunction with another rheumatologic disease, such as systemic lupus erythematosus or rheumatoid arthritis. In these cases, the treatment plan has to also factor in the treatment and symptoms of the underlying autoimmune or chronic inflammation condition.
Many times complications associated with Sjögren’s syndrome are related to decreased saliva and tear production. Individuals struggling with chronic dry eyes might also be at increased risk for secondary infections in the tissues surrounding the as well as possible damage to the cornea.
In the case of chronic dry mouth, Sjögren’s syndrome sufferers are often at increased risk for things like dental decay, gingivitis, and oral yeast infections such as thrush. Painful swelling and salivary gland infections are also somewhat common in patients with Sjögren’s syndrome.
Many Sjögren’s syndrome sufferers also experience occasional pain and stiffness in their joints along with mild swelling. These symptoms are even more likely in individuals with secondary Sjögren’s syndrome occurring along with rheumatoid arthritis or lupus.
Some individuals with Sjögren’s syndrome will also develop a rash on the arms and legs. This is often related to inflammation in small blood vessels. Inflammation in the lungs, liver, and kidneys may occur. Some Sjögren’s syndrome sufferers also complain of periodic numbness, tingling, and weakness in their extremities.
What Causes Sjögren’s Syndrome?
The underlying cause of Sjögren’s syndrome is not fully understood. It’s known to be an autoimmune disorder and is more common in individuals who have abnormal proteins in the blood. A decrease in tears and saliva production seems to be linked to inflammation in the glands that produce these fluids. Like many autoimmune conditions, genetic factors likely predispose people to develop Sjögren’s syndrome.
How is Sjögren’s Syndrome Diagnosed?
Chronic or recurring problems dry eyes and dry mouth may are often early signs of Sjögren’s syndrome. Though they can also be caused by a myriad other conditions, or as a side effect to many common medications.
Diagnosing Sjögren’s syndrome starts with a basic physical examination and symptom analysis. This is usually followed by blood tests to look for protein markers that indicate an autoimmune disorder.
Special tests may need to be performed to assess the decrease in tear or saliva production. This often includes a comprehensive eye exam as well as blood tests to detect the presence of antibodies. This includes anti-nuclear antibodies, anti-SSA, and SSB antibodies as well as other rheumatoid factors. In some cases, a biopsy of an affected saliva gland may be warranted.
How Is Sjögren’s Syndrome Treated?
An effective Sjögren’s Syndrome treatment plan usually focuses on treating the most severe symptoms. In the case of chronic dry eye caused by Sjögren’s Syndrome, artificial tears or other prescription eye drops might need to be applied regularly. Not only will this help flush the eyes, but it will also aid in maintaining the natural fluid balance the eyes rely on to function properly.
In some cases, treatments might need to be performed to clear blocked tear ducts and reduce inflammation in the glands around the eyes. The Cyclosporine in Restasis tends to help increase natural tear production.
When it comes to a treatment plan for chronic dry mount, increased hydration, chewing sugarless gum, or taking prescription saliva substitutes may help alleviate symptoms. Treating any existing gingivitis or other oral infections will also go a long way toward maintaining a healthy mouth and maximizing saliva production.
There are also prescription medications like pilocarpine and cevimeline that help boost natural saliva production in the mouth. Anti-fungal medications might be used to treat a case of thrush or another type of oral yeast infection.
Your physician might also recommend using humidifiers and the occasional use of nasal saline irrigation technique to help address nasal dryness. Individuals who experience acid reflux may also need proton-pump inhibitors and H2 blockers to help lessen symptoms.
Hydroxychloroquine like Plaquenil is sometimes used to help treat rheumatoid arthritis and lupus. Sjögren’s Syndrome sufferers who develop joint pain may require treatment with corticosteroids like prednisone. In some cases, immunosuppressive agents such as Methotrexate, Azathioprine, Mycophenolate, or Cyclophosphamide may be needed to address complications caused by other autoimmune reactions in the body.
Sjögren’s Syndrome might start with symptoms that only seem minor at first. They may even go unnoticed in the face of more significant autoimmune disorder symptoms. Though left untreated Sjögren’s Syndrome can have an increasingly negative impact on your overall quality of life.
If you’ve been struggling with chronic dry eye, chronic dry mouth, acid reflux, or similar symptoms, and you have previously been diagnosed with an auto-immune disorder, you should mention it to your physician.