What is Sjögren’s Syndrome
Sjögren Syndrome - Auto-immune Disease
Sjögren's syndrome is a chronic autoimmune disease characterized by the abnormal production of extra antibodies in the form of white blood cells which attack the moisture-producing glands in the body, causing dry eyes (inflammation of the glands that produce tears (lacrimal glands) which leads to decreased water production for tears and eye dryness.
There is a primary disease that occurs independent from other associated diseases. The secondary disease is associated with other auto-immune diseases, such as systemic lupus, rheumatoid arthritis, scleroderma and relapsing polychondritis.
It also causes dry mouth with inflammation of the glands that produce the saliva in the mouth (salivary glands, including the parotid glands).
I had lupus for several years before I got this disease. As always, I wanted to understand the disease and immediately ordered "The New Sjögren's Syndrome Handbook" by Dr, Wallace (the best author on autoimmune disease in my humble opinion).
The cause remains unknown, but it does tend to run in families with auto-immune diseases, thyroid disease or juvenile diabetes.
About 90% of patients are female, over 4,000,000 suffer from Sjögren’s syndrome, yet it is basically unknown to most people. Often it goes undiagnosed; however, the symptoms may be minor or debilitating.
All instances of Sjögren’s syndrome are systemic, affecting the entire body. Sjögren’s can cause joint pain or inflammation (arthritis), Raynaud's phenomenon, lung inflammation, lymph-node enlargement, kidney, nerve, and muscle disease.
Other common diseases associated with Sjögren syndrome is autoimmune thyroiditis, detecting by thyroid blood tests, heartburn and difficulty swallowing can result from esophageal reflux disease and it may rarely cause liver problems.
As the symptoms of Sjögren’s syndrome mimic other conditions and diseases, on average it takes 7 years to get a diagnosis.
Diagnosing Sjögren's Disease
Sjögren's is a difficult disease to diagnose as there is no specific test for this disease. Some of there symptoms could occur as a reaction of a medication, especially dry mouth.
Some blood tests your doctor may order:
- Certain types of blood cells
- Antibodies that are common in Sjögren's syndrome
- Evaluate evidence of inflammatory conditions
- Blood tests that indicate liver and kidney problems
An ophthalmologist can examine your eyes and often see if they are extra dry. There is a Schirmer Tear test they may use to confirm a dry eye diagnosis.
Sjögren's Disease may also attack other organs of the body, and it may cause frequent bronchitis or in my case the lung disease of brochioectasis.
Chronic fatigue, arthritis and other problems may occur that mimic other diseases, which is one reason it is so difficult to diagnose.
Treatment for Dry Eyes
Treatment for the eyes is important. Dry eyes have a gritty feeling and dryness leads to eye irritation, which can cause eye infections and serious abrasion of the dome of the eye (cornea).
Restasis or Xiidra is often prescribed for the eyes to increase tear production, most doctors also recommend using eye drops at least 5 times a day, plus a get lubricant in bed at night.
Sometimes physicians will insert plugs made of silicone or other material into the openings that normally drain tears which allows the patient to retain tears on the ocular surface for a longer period of time.
There is evidence that taking Omega 3 by mouth may improve dry eye symptoms. Essential fatty acids are also found in flaxseed oil and fish oil supplements. Clinical trials are now being conducted.
Treatments for Dry Mouth
Treatment for dry mouth is equally important. Mouth dryness is uncomfortable, and it can lead to swallowing difficulties, dental decay, gum disease, mouth sores and swelling, stones and infection of the parotid gland inside the cheeks.
Dry lips are also a problem. Seeing your dentist for regular cleaning and evaluation is very important. Brushing your teeth frequently with a product like Biotine toothpaste and be sure to floss daily.
There is also a Biotene mouth moisturizer available for use at night. Sipping water frequently throughout the day and using sugarless mints and gum help.
There are two medications that may be prescribed: pilocarpine (Salagen) and cevimeline (Evoxas). Sometimes Plaquenil, prednisone, Imunan and Cytoxan have been used.
It is possible to get oral candidasis (thrush, a yeast infection) in your mouth from the dryness, and I can only say I know why babies who get thrush cry so much. It is thoroughly miserable. Treatments include Nystatin (a mouth rinse) and Clotrimazole (lozenges). Fluconzole pills are used for recuurent fungal infections.
It us also recommended that you use a saline spray for you nose to moisten those mucous membranes.
What is Sjögren's Syndrome?
If you have any of these symptoms, I suggest you write down all the problems, and then, see your family physician, an eye doctor and a dentist.
They can do a biopsy of your mouth to prove you have the diseas,e but I think if you have the symptoms of dry eyes, nose and mouth you can be fairly certain you are dealing with Sjögren’s syndrome.
The copyright, renewed in 2018, for this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.