Sjogren's Syndrome

What Is Sjogren's Syndrome?

When you have Sjogren's syndrome, your eyes, mouth, and other parts of your body get dried out. There are treatments that bring relief, though.

It's natural to worry when you learn you've got a lifelong disease that will need regular care. Keep in mind that most people with Sjogren's stay healthy and don't have serious problems. You should be able to keep doing all the things you love to do without making many changes.

Sjogren's causes your immune system to go haywire and attack healthy cells instead of invading bacteria or viruses. Conditions like this are called autoimmune diseases. Your white blood cells, which normally protect you from germs, attack the glands that are in charge of making moisture. When that happens, they can't produce tears and saliva.

Dry eyes and dry mouth are the most common symptoms. You can sometimes get problems in other parts of your body, such as swollen glands around your face and neck, dry skin or nasal passages, or painful and stiff joints.

About half of people with Sjogren's also have another autoimmune disease, like rheumatoid arthritis or lupus. That can sometimes make it harder for your doctor to give you a diagnosis.

You'll need to take medicine throughout your life to help you manage your symptoms. You can buy some kinds in a drugstore without a prescription, such as drops that keep your eyes moist. Your doctor can prescribe other drugs that boost the amount of saliva in your mouth.

Causes

Doctors don't know the exact cause. You may have genes that put you at risk. An infection with a bacteria or virus may be a trigger that sets the disease in motion.

For example, let's say you have a broken gene that's linked to Sjogren's, and then you get an infection. Your immune system swings into action.

White blood cells normally lead the attack against the germs. But because of your faulty gene, your white blood cells target healthy cells in the glands that make saliva and tears. There's no let-up in the fight, so your symptoms will keep going unless you get treatment.

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Symptoms

The symptoms of Sjogren's vary a lot from person to person. You may have just one or two, or you may have many. By far, the most common symptoms are:

Dry mouth. Some people say their mouth has a chalky feeling. Others say it seems like cotton. You may find it hard to swallow. The dryness can also lead to yeast infections in your mouth.

Since you don't have enough saliva, which helps protect your teeth from decay, there's a chance you may get more cavities than other people. You could also get inflammation of your gums, called gingivitis.

Dry eyes. Your eyes may also burn, itch, or feel gritty. It doesn't always happen, but you could get infections around your eyes. It can harm your cornea, which is your eye's clear, outer layer.

Sjogren's can sometimes affect other parts of your body. You can have dryness in your throat, nose, lips, or skin. The glands in your neck and face might swell up. Women may get dryness in their vagina.

Some people also get swelling, pain, and stiffness in their joints. This can happen even if you don't also have rheumatoid arthritis, which has those same symptoms.

You may also get heartburn, a sensation of burning that moves from your stomach to your chest.

It's rarer, but you could have other problems like inflammation in your lungs, liver, and kidneys. Some people also say they feel tired and have numbness and tingling in some parts of their body.

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Getting a Diagnosis

It can be tricky to diagnose Sjogren's syndrome, because the symptoms sometimes look a lot like some other diseases. To get clues, your doctor will give you a physical exam and may ask you questions such as:

  • Do your eyes itch or burn often?
  • Are you getting a lot of cavities in your teeth?
  • Does your mouth get dry? How about your lips?
  • Do you have stiff or painful joints?

Your doctor may ask you to get some blood tests. He'll take some blood from your vein and send it to a lab to get checked.

The blood tests can show if you have germ-fighting proteins (antibodies) that many people with Sjogren's have. They can also measure inflammation in your body, another sign that you have the disease.

Your blood tests can also reveal if you have high amounts of proteins called immunoglobulins. These are part of your body's infection-fighting system. A high level could be a sign of Sjogren's.

Questions for Your Doctor

  • What can I do for my dry eyes?
  • Is there anything I can do to moisten my mouth?
  • What can I do for joint pain?
  • Because of my immune system problem, is it safe for me to get a flu shot?

Treatment

There's a lot you can do to manage your symptoms. Sometimes medicines you can buy without a prescription are enough to bring relief.

For instance, drops called "artificial tears" can keep your eyes from drying out. You'll need to use them regularly throughout the day. There are also gels that you put on your eyes at night. The advantage of the gels is that they stick to your eye's surface, so you won't need to apply them as often as the drops.

If artificial tears aren't helping, your doctor may prescribe drugs for your dry eyes, including:

Lacrisert is tiny rod-shaped medicine. You put it into your eye with a special applicator, usually once or twice a day. Restasis comes in the form of drops, which you use twice a day.

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To help your dry mouth, your doctor may prescribe drugs that boost the amount of your saliva, including:

There are other treatments for some of the less common symptoms of Sjogren's syndrome. For instance, if you get yeast infections in your mouth, your doctor might prescribe anti-fungal medicine.

If you get heartburn, your doctor may give you medicines that curb the amount of acid in your stomach.

Your doctor may also suggest a medicine called Plaquenil (hydroxychloroquine) to treat your joint pain. It's a drug that's also used to treat malaria, lupus, and rheumatoid arthritis.

It's rare, but some people with Sjogren's get symptoms throughout the body, including belly pain, fever, rashes, or lung and kidney problems. For those situations, doctors sometimes prescribe prednisone (a steroid) or an anti-inflammation drug called methotrexate.

Taking Care of Yourself

There are lots of steps you can take on your own to help manage your symptoms. For example, sipping water frequently can help a dry mouth. Chewing gum or sucking on a candy can stimulate saliva flow and help keep your mouth moist. Be sure they're sugar-free, so you don't get cavities.

Also ask your doctor, dentist, or pharmacist about mouthwashes or sprays that can relieve dryness. You might need to try several until you find a product that works for you.

Keep up with toothbrushing and flossing to avoid getting cavities. Schedule regular checkups with your dentist.

For dry eyes, a lot of people find that using a humidifier or vaporizer at night can help. These machines also can help your dry mouth or nose. Also for dry nose, try a nasal saline spray or gel.

If dry skin is a problem, use warm water, not hot, when you bathe or shower. Instead of using a towel after showering, let yourself "drip dry." Your skin will absorb the moisture from the shower.

What to Expect

You'll need to keep up with medicine throughout your life to get relief from symptoms.

Everyone's experience is different. With the right care, you can lead an active life.

It can help to get in touch with others who are going through the same thing. You can compare notes about symptoms and get ideas about what brings relief. Talk to your doctor about support groups in your area. Reach out to family and friends, too. They can be a great source of emotional support.

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Getting Support

The Sjogren's Syndrome Foundation can connect you with others through support groups and conferences. Visit sjogrens.com, where you'll also find self-help booklets, newsletters, tips, and videos.

WebMD Medical Reference Reviewed by David T. Derrer, MD on September 05, 2014

Sources

SOURCES:

Sjogren's Syndrome Foundation: "About Sjogren's Syndrome."

American College of Rheumatology: "Sjogren's Syndrome," "Methotrexate."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers about Sjogren's Syndrome."

NHS: "Treating Sjogren's Syndrome."

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