Sjögren’s syndrome (pronounced "SHOW-grins") is a surprisingly common condition that many people are not aware exists.
This condition causes decreased saliva production and decreased tear production, leading to dry mouth and eyes.
There are many treatment options that can help with this disease and avoid its unpleasant symptoms.
Here, you'll find all that you want to know about Sjögren’s syndrome.
What is Sjögren’s Syndrome?
Sjögren’s syndrome is an autoimmune condition in which someone’s immune system attacks their body’s own tissues and cells.
In this disease, the immune system will attack the lacrimal gland (the glands that produce tears) and the salivary glands (the glands that produce saliva).
People with this condition ultimately develop dry, irritated eyes and a dry mouth.
Dryness of the eyes can lead to vision problems and discomfort in the eyes.
Similarly, dryness of the mouth can make it difficult to talk, eat, swallow, and increase the risk of oral diseases.
When the immune system is functioning normally, immune cells in the body will attack bacteria, cancer, and other cells that can cause disease.
In contrast, someone who has an autoimmune disease, however, immune cells will attack cells that are actually part of the individual’s own body.
The type of autoimmune disease that someone has depends on which cells in their body the immune system attacks.
Like most autoimmune conditions, doctors do not fully understand exactly what actually causes Sjögren’s syndrome to develop.
Autoimmune diseases are still an area of ongoing research, and their underlying cause is not typically known.
Because Sjögren’s syndrome primarily affects glands that produce fluids, almost all of the symptoms are caused by dryness that affects the mouth, eyes, or sometimes the vagina.
Symptoms of Sjögren’s syndrome can include:
- Dry eyes
- Dry mouth
- Vaginal dryness
- Blurred vision
- Itchiness of the eyes
- Grainy feeling in the eyes
- Intolerance to bright lights
- Chalky feeling in the mouth
- Feeling like the mouth is full of cotton
- Difficulty speaking
- Difficulty swallowing
- Decreased ability to taste food
- Tooth decay
- Infections in the mouth
- Discomfort during intercourse
- Vaginal dryness during intercourse
While Sjögren’s syndrome primarily causes dryness of the mouth and eyes, it may also lead to other, more serious symptoms if it affects other parts of the body or if its effect is severe. Complications of can include:
- Chronic pain
- Profound fatigue
- Nerve problems
- Organ damage or injury
This condition can also occur simultaneously with other autoimmune diseases, generally occurring on its own in about half of cases and with other autoimmune diseases the other half of the time.
Because the cause of Sjögren’s syndrome is not fully understood, there are limitations to knowing the risk factors for this condition. There are, however, several known factors that may influence your risk of developing this autoimmune disease. The risk factors for Sjögren’s syndrome include:
- Age - Most people are 40 years old or older.
- Gender - Females are about ten times more likely to develop this condition than males.
- Autoimmune disease - Individuals who already have an autoimmune disease are more likely to develop this condition than those without any history of autoimmune problems.
- Genetics - Those who are genetically related to someone with any autoimmune disease, not just Sjögren’s, are more likely to develop this condition.
- Infections - Autoimmune condition are more likely to develop after an infection.
Sjögren’s syndrome can be difficult to diagnose, with the average time it takes to receive a diagnosis being almost three years.
Unfortunately, there is no single test that can be used to diagnose this disease.
A diagnosis for this condition requires combining the results of multiple types of tests, an interview of your symptoms and medical history, and ruling out other conditions that could explain your symptoms.
Sjögren’s syndrome medical tests
- Blood tests - Blood tests can reveal the presence of antibodies that develop in people with Sjögren’s syndrome; however, not everyone will have these antibodies.
- Schirmer test - The Schirmer test measures tear production by the eyes, indicating whether the eyes are producing enough tears to keep themselves moist.
- Rose Bengal and/or Lissamine Green - Ophthalmic dyes can be used to indicate dry areas on the surface of the eyes.
- Salivary flow - Salivary flow tests measure the quantity of saliva production over a certain period of time.
- Salivary gland biopsy - A biopsy can reveal the presence of immune cells in the salivary glands, supporting a diagnosis of Sjögren’s syndrome.
Sjögren’s syndrome is typically diagnosed by a rheumatologist - a doctor who specializes in conditions that include diseases caused by an over-active immune system.
Rheumatologists are best qualified to quickly and efficiently provide a diagnosis and test for related autoimmune conditions.
Someone who suspects they may have this disease should see a rheumatologist as soon as they can.
There are two main types of treatments for Sjögren’s syndrome, and a combination of both is often used.
Treatments will often include both decreasing the abnormal immune response and treating the dryness-related symptoms that the condition causes.
Treatments to actually regulate the immune system may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) - These drugs are often the first medications used when trying to treat mild autoimmune disease. NSAIDs have less of an effect than other medications but have fewer side effects.
- Corticosteroids - Steroids can have serious long-term side effects; however, they suppress the immune system and can be very effective at reducing symptoms.
- Disease-modifying anti-rheumatic drugs (DMARDs) - DMARDs can help to regulate abnormal immune responses and may be an effective method of managing the underlying causes of autoimmune conditions. These drugs, however, do have potential side effects.
Other treatments include medications to promote hydration in the eyes and mouth. These can include medicated rinses and eye drops that help to alleviate the symptoms of dryness.
Ultimately, the best treatment for Sjögren’s syndrome will be unique for everyone. Those concerned about potentially having this condition should consult with their rheumatologist to see what treatment options will be best for them.
At Southwest Florida Rheumatology, we have extensive experience with how to effectively manage Sjögren’s syndrome.