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Sjögren's syndrome

Sjögren’s syndrome is a chronic (ongoing) disease in which a person’s immune system attacks their lacrimal (tear) glands and salivary glands. The resulting inflammation and destruction of these glands leads to the symptoms of dry eyes and a dry mouth that characterise the condition.

Sjögren’s syndrome can occur as a primary condition, when it occurs by itself, or as a secondary condition, when it is associated with other established connective tissue diseases such as rheumatoid arthritis and systemic lupus erythematosus (also known as SLE or lupus).

Symptoms

As well as causing dry eyes and a dry mouth, Sjögren’s syndrome has the potential to affect almost any organ system in the body. Other symptoms can include fatigue, nosebleeds, fevers, gastric reflux, vaginal dryness, arthritis, muscle pains and skin rashes.

The syndrome is typically seen in women at around the time of menopause. It can also occur in men, but the female to male ratio is 9:1.

People with Sjögren’s syndrome have an increased risk of developing other diseases such as kidney disease, liver disease and, importantly, lymphoma (cancer of the lymphatic system). It is therefore very important for people with this syndrome to have regular medical check-ups.

Treatments

There is no cure for Sjögren’s syndrome. Treatment is aimed at relieving the symptoms, so can vary widely from person to person.

For dry eyes, you can use artificial tears. How frequently these should be used will depend on the severity of the dryness. Using spectacles with windshields and avoiding drying environments might also be helpful.

For a dry mouth, it’s best to avoid factors that may make the dryness worse, such as alcohol (including mouthwashes containing alcohol), smoking and mouth breathing. Anticholinergic medicines, which are often found in over-the-counter cold and cough medications, should also be avoided because they can cause a dry mouth and dry eyes.

Because there is inadequate saliva, people with Sjögren’s syndrome are more prone to dental problems. This can be protected against by rinsing your mouth regularly, particularly after meals, and avoiding fluids that contain sugar. A dental check-up every 3-6 months is recommended.

Artificial saliva might be useful, especially in drying environments such as on aeroplanes. People who don’t produce saliva might also find vitamin E oil or mouth moisturising gels (e.g. Oral Balance) helpful.

People with Sjögren’s syndrome are at increased risk of developing oral thrush. Symptoms of this include mouth or tongue burning, intolerance to spicy foods, or splitting in the corners of the mouth. Once this condition is diagnosed, it can be treated with medication available on prescription.

While dry eyes and dry mouth are the most common symptoms of Sjögren’s syndrome, many other symptoms can occur. These often require careful assessment and management by a medical professional.


 

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