Sjögren Syndrome

What is Sjögren syndrome?

Sjögren syndrome is an autoimmune disorder. This means that the body’s own immune system attacks its own healthy cells and tissues by mistake. In this case, it attacks the glands that produce moisture. It commonly causes dry skin, dry eyes, and dry mouth.

There are two types of Sjögren syndrome:

• Primary Sjögren. This is the term used when Sjögren syndrome appears by itself, without any other disease or illness. About half of cases are primary.

• Secondary Sjögren. This is when Sjögren syndrome occurs along with other autoimmune disorders, such as scleroderma, lupus, or rheumatoid arthritis.

What causes Sjögren syndrome?

Sjögren syndrome is an autoimmune disorder where the immune system reacts against its own healthy tissue. Healthcare providers have not determined the exact cause but suspect that genetics and environmental factors may play a role.

Who is at risk for Sjögren syndrome?

Sjögren syndrome is one of the most common autoimmune disorders in the U.S. It affects women more often than men. People with secondary Sjögren will have Sjögren syndrome in addition to another autoimmune disorder such as rheumatoid arthritis, lupus, or scleroderma.

What are the symptoms of Sjögren syndrome?

Symptoms of Sjögren syndrome can range from mild to severe—from discomfort to debilitating symptoms that can affect your overall quality of life. The two most common symptoms of Sjögren syndrome are dry eyes and dry mouth. From there, the disease can evolve into symptoms that affect the entire body.

Symptoms can include:

• Dry mouth, which can lead to trouble with talking, chewing, or swallowing

• Dry eyes that can have a gritty or burning feeling

• Dry, peeling lips

• Soreness or cracking on the tongue

• Dry or sore throat

• Tooth decay

• Dry skin

• Vaginal dryness

• Dry nose

• Changes in the ability to taste or smell

• Tiredness (fatigue)

• Joint pain

• Digestive issues

• In some cases, Sjögren can cause nervous system symptoms such as weakness and numbness, arthritis, kidney disease, and muscle inflammation.

How is Sjögren syndrome diagnosed?

Sjögren syndrome is often hard to diagnose. That’s because the symptoms can overlap or look like those of other conditions, including chronic fatigue syndrome, fibromyalgia, lupus, rheumatoid arthritis, or even multiple sclerosis.

Specialists called rheumatologists use a point-based test to figure out if your symptoms might be related to Sjögren syndrome. The higher number of points you have, the more likely it is that you have the disease.

Along with physical symptoms, other tests that can help identify Sjögren syndrome include blood tests, eye tests, and dental tests. Some of those tests include:

• Antinuclear antibody blood test

• Rheumatoid factor blood test

• Sjögren syndrome antibody blood markers

• Erythrocyte sedimentation rate blood test

• Immunoglobulins blood test

• Schirmer’s test to measure tear production

• Tests to check the eyes for dryness

• Salivary flow to measure saliva production

• Salivary scintigraphy to measure salivary gland function

• Salivary gland biopsy

How is Sjögren syndrome treated?

There is no cure for Sjögren syndrome, but certain treatments or a combination of treatments can help ease symptoms. The key is to work with a rheumatologist to help you manage symptoms.

Common eye and mouth symptoms can often be treated with over-the-counter (OTC) eye drops and mouth rinses. Your healthcare provider may be able to prescribe stronger formulas if OTC versions don’t help.

If your symptoms from Sjögren syndrome affect other areas of the body, you might find relief from some of the immunosuppressive medicines that are used to treat other autoimmune disorders. Pain medicine might be needed, too, depending on your symptoms.

Living with Sjögren syndrome

There are treatments to help with dry eyes, dry mouth, and pain. But changing your diet can also play a role in easing Sjögren syndrome symptoms. For example, it may be helpful to avoid alcohol, acidic drinks, carbonated drinks, and foods that are spicy, hard, crunchy, or acidic. All of these tend to make symptoms worse. Smooth, soft, and creamy foods like soups, casseroles, and pasta dishes are often good choices. Some people with Sjögren syndrome also have celiac disease and need to avoid gluten as well.

Experts think that omega-3 fatty acids may help relieve dry eye symptoms. Clinical trials on using supplements are underway.

The Sjögren's Foundation also suggests that you:

• Don't use medicines that might further dry your eyes, such as certain blood pressure medicines, antihistamines, and antidepressants. Talk with your healthcare provider about these choices.

• Don't sit near air conditioning or heating vents. The dry air can also contribute to dry eyes.

• Use preservative-free artificial tears frequently and regularly daily, even if you don’t have symptoms. Try sleeping with special eye gels that your healthcare provider can prescribe.

• Use warm compresses daily to soothe irritated eyelids.

• Brush your teeth after each meal. Floss daily to help prevent cavities caused by dry mouth.

• Get routine dental checkups at least twice a year.

• Increase your intake of fluids during the day with small sips of water.

• Chew sugarless gum or suck on sugar-free candy, if needed, to help lubricate your mouth.

• Don't use mouthwash that contains alcohol.

• Try using a room humidifier at home or at your workplace, especially during winter months.

• When reading, watching TV, or doing computer work, take blink breaks to rest and stabilize the surface of eyes.

Key points about Sjögren syndrome

• Sjögren syndrome is a chronic autoimmune disorder. It causes your white blood cells to fight the glands that produce your body’s moisture.

• It affects more women than men. The two most common symptoms are dry eyes and dry mouth.

• Common eye and mouth symptoms can often be treated with over-the-counter eye drops and mouth rinses.

• Changing your diet can also play a role in easing symptoms.

• There is no cure, so it's important to work with a specialist called a rheumatologist to manage your symptoms.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.