When you have a healthy body, your immune system attacks foreign invaders. However, some people’s immune systems mistake healthy tissue for foreign material, and attack their own bodies. These conditions are called autoimmune disorders.
Sjogren’s syndrome is one such autoimmune disorder.
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What Is Sjogren’s Syndrome?
Sjogren’s syndrome primarily affects the lacrimal and salivary glands that help our bodies create moisture in the mouth and eyes (saliva and tears). People with Sjogren’s syndrome can’t produce the moisture their body needs.
It’s a systemic disease that affects the entire body, and symptoms can stay steady or worsen over time. There’s no single progression of this disease, creating challenges for both patients and providers.
Sjogren’s syndrome can appear alone without any other autoimmune diseases (primary) or along with other autoimmune diseases (secondary). Primary Sjogren’s syndrome is often more aggressive, causing more symptoms and excessive dryness compared to the secondary type.
While often thought of as a rare disease, Sjogren’s syndrome affects between one and four million people in the US, making it one of the most common autoimmune diseases.
Symptoms of Sjogren’s Syndrome
A common symptom of Sjogren’s syndrome is dry mouth, which also increases your risk of cavities. In addition, it can make it difficult to swallow and speak. Some people find relief from chewing gum or sucking on hard candies.
Dry eyes is another common symptom; many people with Sjogren’s syndrome report feeling like something is in their eyes or experiencing a burning sensation.
Sjogren’s syndrome can affect your whole body, causing dry skin, joint pain, rashes, fatigue, and inflammation of the organs.
Symptoms vary from person to person but can include:
- Neurological problems like memory loss and headaches
- Dry nose, nosebleed, and recurrent sinusitis
- Changes in taste or smell
- Burning or dry throat
- Heartburn, esophagitis, reflux, or difficulty swallowing
- Dry eyes, infections, and corneal ulcerations
- Mouth sores, dry mouth, and dental decay
- Difficulty chewing, speaking, or tasting
- Peeling or dry lips
- Swollen and painful glands
- Recurrent interstitial lung disease, bronchitis, or pneumonia
- Respiratory issues like coughing or shortness of breath
- Abnormal liver function
- Interstitial cystitis
- Active autoimmune hepatitis
- Arthritis and joint or muscle pain
- Primary biliary cholangitis
- Vaginal dryness or vulvodynia
- An inability to focus or concentrate
- Renal tubular acidosis, interstitial nephritis, or glomerulonephritis
- Upset stomach, autoimmune pancreatitis, and gastroparesis
- Irritable bowels or autoimmune gastrointestinal dysmotility
- Raynaud’s or peripheral neuropathy
- Fatigue, lymphoma, or vasculitis
- Sensitivity to UV light
Causes of Sjogen’s Syndrome
There are no specific causes or risk factors for developing Sjogren’s syndrome. However, nine out of ten people with the condition are women — postmenopausal women are even more likely to develop Sjogren’s syndrome. Thus, researchers are currently trying to determine whether estrogen is associated with Sjogren’s syndrome because of it being so much more common in women.
Other autoimmune diseases are often present with Sjogren’s syndrome, and having a family history of the condition seems to increase someone’s risk of developing it.
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How Is Sjogren’s Syndrome Diagnosed?
Sjogren’s syndrome is complex, and the symptoms aren’t always present at the same time. Many times, physicians treat each symptom individually as it appears, not recognizing that it’s a systemic disease.
There’s no single test that confirms whether someone has Sjogren’s syndrome. Rheumatologists, eye doctors, dentists, and physicians may perform tests and ask questions to determine a Sjogren’s syndrome diagnosis, including:
- Blood tests for marker antibodies SS-A and SS-B
- Eye tests, including the Schirmer, Rose Bengal, and Lissamine Green tests.
- Dental tests to measure salivary flow and a salivary gland biopsy.
You might also get asked questions like:
- How long have you had dry eyes?
- Does it feel like there’s something in your eye?
- How often do you use eye drops?
- How long have you had a dry mouth?
- Have you experienced salivary gland swelling?
- Can you swallow foods without liquid?
Treatments for Sjogren’s Syndrome
In some cases of Sjogren’s syndrome, lifestyle changes can help relieve symptoms like fatigue and acid reflux. Some over-the-counter products can also help alleviate dryness and inflammation.
Sjogren’s syndrome patients often use a combination of management strategies, prescription medications, and over-the-counter products. In most cases, patients will eventually need a prescription medication throughout the course of their disease to help control it and reduce the risk of complications.
Various medications can help people with Sjogren’s syndrome; however, no single treatment has been proven to slow its progression or treat every aspect of the condition.
Some common treatments for Sjogren’s syndrome include:
- NSAIDs are typically a first-line therapy used to treat Sjogren’s syndrome by reducing inflammation. These medications reduce the production of prostaglandins in the body, relieving pain and inflammation. This treatment includes over-the-counter NSAIDs like ibuprofen, aspirin, and naproxen. In addition, there are various prescription NSAIDs available for Sjogren’s syndrome patients.
- Corticosteroids, like prednisone, are fast-acting medications that can be highly successful for treating severe Sjogren’s syndrome symptoms and flare-ups. Long-term use is common with corticosteroids — patients will often start at a high dose and taper down to a maintenance dose to control their symptoms.
- DMARDs help regulate abnormal immune responses instead of treating symptoms. They are commonly prescribed for Sjogren’s syndrome patients; however, unlike corticosteroids, they do not produce an immediate effect. DMARDs take time to work on the symptoms before patients feel a difference.
- Other treatments targeted at specific symptoms, like prescription eye drops for dry eyes and medications to relieve dry mouth.
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When to Talk to Your Doctor About Sjogren’s Syndrome
If you think you have Sjogren’s syndrome, talking to your doctor is never a bad idea. However, one complication of the condition is a high risk of developing lymphoma, which relates to the immune system.
If you notice changes in the size of your salivary gland, swelling, or other lymphoma symptoms — night sweats, fatigue, fever, and unexplained weight loss — you should talk to your doctor.
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