According to a 2009 National Arthritis Dataworkgroup report by the American College of Rheukateology, Sjögren’ s patients with minor autoimmune vascular diseases numbered about 400,000.
When treating Sjögren’s patients, the integration of multi-disciplinary teamwork is essential and communication is critical.
What is sjögren’s syndrome?
Sjögren’s (“SHOW-grins”) is a systemic autoimmune disease that affects the entire body.
Along with symptoms of extensive dryness, other serious complications include profound fatigue, chronic pain, major organ involvement, neuropathies, and lymphomas.
Sjogrens syndrome is an autoimmune disorder that attacks healthy cells instead of attacking bacteria and viruses.
Your cells attack the specialized glands which are responsible for releasing water to your body.
If it happens, it will cause the tears or salivary glands to dry up.
However, the treatments help.
When you get diagnosed with a life-long disease you are usually concerned.
It should be noted that the majority of Sjogrens patients are healthy but have no serious medical problems.
Sjögren’s syndrome causes and risk factors
Sjögren’s syndrome is an autoimmune disease, which means something triggers your immune system to attack healthy cells.
This attack damages the tear system in your eyes and the salivary glands in your mouth.
Exactly what causes this abnormal immune system response is not clear.
These factors may play a role:
- Environmental factors.
- Genetics.
- Sex hormones (the condition affects more women than men).
- Viral infections.
It is not known what causes Sjogren’s syndrome.
It appears that your genes may play a role, combined with an outside trigger such as a bacteria or virus.
It’s also more likely to affect people who have conditions such as rheumatoid arthritis, scleroderma and lupus.
Doctors are unable to tell what caused the illness.
You might have a gene that puts you on the brink of disaster.
Infection with bacteria and viruses can initiate the development of disease.
It’s the body’s defense mechanism.
White cells usually carry on battling germinating bacteria.
Because the wrong gene exists white blood cells target healthy cells within the glands responsible for salivation and tear production.
There is no break from fighting, and so the symptoms cannot go away until treatment is provided.
Other things that could increase your chances of having sjogrens include:
Age.
Irritable Bowel syndrome
There also seems to be a significant number of people who have both Sjögren’s syndrome and celiac disease and/or symptoms of irritable bowel syndrome (bloating, abdominal pain, diarrhea and/or constipation).
If you have gastrointestinal symptoms, you can work with a registered dietitian (RD) to find out what food sensitivities you have.
An RD can then also help you to create a food plan that works well for you and provides the nutrients you need.
Sjögren’s syndrome. Complications
Dry Mouth
If your saliva does not help protect your mouth from deterioration, there can be an increase in cavities.
You could even have a swelling and yeast infection in your mouth known as gingivitis.
Sometimes you have a hard time swallowing.
Dry nose
A dry nasal area can cause nosebleeds and sinusitis.
Dry eyes
Dry eyes can cause infection around the eyes.
It is possible you will see alterations to the vision.
Others
Other lesser common illnesses that have a direct association with Sjogren include: irritable intestinal disorder, IBS, Interstitial cystitis.
Sjögren’s syndrome symptoms
The more common symptoms of Sjogren’s syndrome include:
- dry eyes (irritation, feeling gritty or itchy, burning)
- dry mouth (or difficulty chewing or swallowing).
- Dry, itchy skin .
- Enlarged salivary glands.
- Fatigue .
- Tooth decay or early tooth loss.
- Vaginal dryness .
Sjogrens symptoms may differ a lot between people.
You might have two or more of the symptoms or you might have multiple.
The most commonly encountered symptom is dry tongue that has an acridic taste or feels like cotton
Weak eyelids which burn and can feel gritty
Dry lips, skin or throat
Dry throat Change in flavor or smell Swollen glands on nose.
Muscle and Joint Pain
Muscle and joint pain or stiffness.
If you have pain or stiffness in your joints or muscles, it can help to: exercise regularly – a mixture of aerobic exercises (such as cycling) and strength and flexibility exercises may be helpful; a physiotherapist can recommend a suitable exercise plan take non-steroidal anti inflammatory drugs NSAIDS.
Dry Mouth
Dry skin
If you have dry skin, it may help to use a moisturizing cream (emollient) every day.
It’s best to not use strong, perfumed soaps. Use emollient soap substitutes instead. Read more about emollients and soap substitutes .
Vaginal dryness Treatments for vaginal dryness include: lubricants – liquids or gels you put inside.
Diagnosis
Sjogren syndromes can be hard to identify despite the fact that their symptoms differ from person to person and may be similar in nature to other diseases.
The side effects from several drugs mimic other symptoms associated with Sjogren Syndrome.
Tests are helpful in identifying and diagnosing other illnesses or Sjogren syndrome.
Tests may include:
- Schirmer’s test – special blotting paper held to the eye is used to assess the degree of tear production eye examination –
- The use of special dyes biopsy – a small piece of salivary gland tissue is removed (usually from the lip) and examined under a microscope
- blood tests – may be used to check the levels of particular immune system cells in the blood, and
- check for any problems with your kidneys or liver.
Blood tests
Your doctor might order blood tests to check for: Levels of different types of blood cells Presence of antibodies common in Sjogren’s syndrome
Evidence of inflammatory conditions
Indications of problems with your liver and kidneys
Eye tests Your doctor can measure the dryness of your eyes.
Sialogram and scintigraphy
This special X-ray can detect dye that’s injected into the salivary glands in front of your ears.
This procedure shows how much saliva flows into your mouth.
Salivary scintigraphy. This nuclear medicine test involves the injection into a vein of a radioactive isotope, which is tracked over an hour to see how quickly it arrives in all your salivary glands.
Sjogren syndrome diagnosis
Because many people with Sjogren’s also have another autoimmune disease – and Sjogren’s symptoms often look similar to others like fibromyalgia.
Treatment for Sjogren’s Syndrome
You will need medical care for all aspects of your health.
There are many types available in pharmacies and you should take a drug test for the strongest ones until the drugs work.
Eye drops
Some drops are called synthetic tears that prevent dryness in the eyes.
It will help keep them in your daily routine.
You can apply the gels to the eyes during the evening.
The advantages of the gel are that it adheres perfectly onto your eye and you will never need to apply it as frequently as drops do.
If artificial tears don’t help your dry eyes, a medical professional can prescribe the following medications to help.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
DMARDs modify the way the immune system functions, so instead of simply treating symptoms, DMARDs regulate abnormal immune responses.
Unlike corticosteroids, these drugs do not produce an immediate effect but take time to have an impact on symptoms and before a patient feels a difference.
Common medications.
Hydroxychloroquine (Plaquenil), a drug designed to treat malaria, is often helpful in treating Sjogren’s syndrome.
Drugs that suppress the immune system, such as methotrexate (Trexall), also might be prescribed.
Treatment
Sjogren syndrome is caused by various organs.
Many patients treat their sjogrens syndrome symptoms with eye drops and mouth irritants using prescription glasses and drinking more often.
Some patients need prescriptions and sometimes surgical treatment.
Your doctor may recommend: a medicine called pilocarpine – tablets that help the body produce more tears and saliva.
Punctal plugs – a procedure to block the tear ducts with tiny man-made plugs to stop tears draining away – this can help keep your eyes covered with a layer of tears, so they do not feel as dry.
Prescription Dry eye treatments
- Restasis® – cyclosporine ophthalmic emulsion.
- Xiidra® lifitegrast ophthalmic solution.
- CEQUA™ Cyclosporine Ophthalmic Solution
- TYRVAYA™ Varenicline Solution
Treatments for a dry mouth
Things you can do If you have a dry mouth, it can help to:
- Practice good oral hygiene, including brushing your teeth with a fluoride toothpaste twice a day.
- Avoid sugary food and drinks, and avoid snacking between meals.
- Use antibacterial mouthwash
- Drink plenty of water regularly
- Chew sugar-free gum.
Over-the-counter options for dry mouth symptoms.
They include: Sucking on sugarless candy and chewing sugar free gum.
If you don’t find that effective, prescription medications are available that can help increase your saliva production.
Sipping water during the day is the easiest way to ease dry mouth.
An artificial saliva product, such as a spray or lozenge, may also help.
People with Sjögren’s syndrome are at increased risk for cavities and should be sure to: Brush and floss after meals and snacks. See a dentist at least twice each year. Talk with the dentist about the use of fluoride
Dry Mouth Prescription Treatments:
- Evoxac® (cevimeline)
- Salagen® (pilocarpine hydrochloride)
- NeutraSal®
Treatments for Joint Pain
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are recommended for the joint pain that may accompany Sjögren’s syndrome.
Low-dose steroids such as prednisone can also reduce joint pain.
Medications called disease-modifying anti-rheumatic drugs , which slow the effects of lupus and rheumatoid arthritis, have been used successfully to treat Sjögren’s syndrome joint pain.
Sjogren syndrome. Home remedies
It’s easy for you to get yourself into the habit of managing symptoms.
Try chew gum or sour candy to increase saliva flow.
Be sure the products are not too sugary to prevent cavities.
Tell the doctors or pharmacist how mouthwash or spray will reduce the discomfort and irritation.
There’ll be some testing until the right product is found.
Brush your teeth regularly.
Schedule regular check-up sessions with the dentist.
Use a humidifier or vaporizer at night to increase the humidity in your home.
Avoid strong soaps that may dry out your skin.
Exercise regularly, eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing.
Eat soft, moist foods if you have trouble swallowing.
Eat smaller, more frequent meals to stimulate saliva flow.
Use warm (not hot) water when taking a shower or bath.
Avoid salty, acidic or spicy foods and carbonated drinks that may be painful if your mouth is dry.
saliva substitutes
There are also products you can buy from pharmacies that may help to keep your mouth moist, known as saliva substitutes.
There are several different types available, including sprays, lozenges (medicated sweets) and gels.
You may need to try a few types to find one that works for you.
But these products do not help prevent mouth infections in the same way that saliva does, so it’s still have to exercise dental hygiene.
Best treatment for Sjogren’s – All Natural TheraLife
Lifestyle and home remedies
Some Sjogren syndromes have a positive response to medication.
For removing the dry eye, you need lubricants for the eyes so the tears can be restored.
Artificial tears in eye drops and eye lubricants are used as eye drops or as ointments to help ease irritation. It can also help prevent eye irritation by using lubrication in the eyes like a tear.
Due to their thicker consistency eye lubrication products can blur your eyes vision and they may be useful overnight.
Your physician may prescribe artificial tears without preservatives to relieve eye irritation.
Preparing for your appointment
Depending on your symptoms, it’s possible to see your doctor first. You may eventually go to a doctor who treats inflammation or osteoarthritis (rheumatologists).
Questions for your doctor about Sjogren’s Syndrome?
Is it possible to have dry eye?
How should one moisturize their mouth?
How can one manage joint disease?
What is your risk factor when getting the flu vaccination in the first place?
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References
National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health_info/Sjogrens_Syndrome/sjogrens_syndrome_ff.asp. Accessed May 23, 2017.
