WHAT IS SJOGREN'S SYNDROME: SYMPTOMS, CAUSES, DIAGNOSIS, AND MORE


Sjogren's syndrome is an immune system condition distinguished by its two most prevalent symptoms: dry eyes and a dry mouth.

Other immune system illnesses, such as rheumatoid arthritis and lupus, are frequently associated with the syndrome. Sjogren's syndrome often affects the mucous membranes and moisture-secreting glands of your eyes and mouth first, resulting in reduced tears and saliva.

Although Sjogren's syndrome can occur at any age, most persons are beyond the age of 40 when they are diagnosed. Women are far more likely to suffer from this illness. The treatment focuses on symptom relief.


WHAT ARE THE SYMPTOMS OF SJOGREN'S SYNDROME?

Sjogren's syndrome has two primary symptoms:
  • Dry eyes: Your eyes may burn, itch, or feel gritty, as if they contain sand.
  • Dry mouth: Your mouth may feel like it's full with cotton, making swallowing and speaking difficult.
Sjogren's syndrome is associated with one or more of the following symptoms:
  • Pain, edema, and stiffness in the joints
  • Dryness of the cervix
  • Chronic dry cough
  • Prolonged exhaustion
  • Swollen salivary glands, especially those below your jaw and in front of your ears
  • Rashes on the skin or dry skin

WHAT ARE THE CAUSES OF SJOGREN'S SYNDROME?

Sjogren's syndrome is a kind of autoimmune disease. Your immune system incorrectly assaults your own cells and tissues.

Scientists don't know why certain people get Sjogren's syndrome. Certain genes predispose people to the condition, but it appears that a triggering mechanism — such as infection with a certain virus or strain of bacteria — is also required.

In Sjogren's syndrome, your immune system attacks the glands that produce tears and saliva first. However, it can also harm other regions of your body, such as:
  • Joints
  • Lungs
  • Skin
  • Nerves
  • Thyroid
  • Kidneys
  • Liver

WHAT ARE THE RISK FACTORS FOR SJOGREN'S SYNDROME?

Sjogren's syndrome is more common in those who have one or more identified risk factors, such as:
  • Age: Sjogren's syndrome is most commonly diagnosed in adults over the age of 40.
  • Sex: Sjogren's syndrome is substantially more common among women.
  • Rheumatic disease: People with Sjogren's syndrome are more likely to develop a rheumatic condition, such as rheumatoid arthritis or lupus.


WHAT ARE THE COMPLICATIONS OF SJOGREN'S SYNDROME?

The most frequent Sjogren's syndrome consequences concern your eyes and mouth.
  • Dental cavities: Because saliva protects the teeth from the germs that cause cavities, if your mouth is dry, you are more likely to acquire cavities.
  • Yeast infections: Oral thrush, a yeast infection in the mouth, is considerably more common in those with Sjogren's disease.
  • Vision issues: Light sensitivity, poor vision, and corneal damage can all result from dry eyes.
Less common complications may have an impact on:
  • The lungs, kidneys, or liver: Inflammation can cause pneumonia, bronchitis, or other lung issues, as well as kidney difficulties and hepatitis or cirrhosis in the liver.
  • Lymph nodes: A tiny fraction of persons with Sjogren's syndrome develop lymph node cancer (lymphoma).
  • Nerves: You may have numbness, tingling, and burning sensations in your hands and feet (peripheral neuropathy).


HOW IS SJOGREN'S SYNDROME DIAGNOSED?

Sjogren's syndrome is difficult to diagnose since the signs and symptoms vary from person to person and might be confused with those caused by other disorders. A variety of drugs have side effects that resemble some of the signs and symptoms of Sjogren's disease.

Tests can help rule out other illnesses and narrow down a Sjogren's syndrome diagnosis.

Blood tests

Blood tests may be ordered by your doctor to check for:
  • Blood cell counts of various kinds
  • Common antibodies seen in Sjogren's syndrome
  • Indications of inflammatory disorders
  • Indications of liver and kidney dysfunction

Eye tests

A Schirmer tear test can be used by your doctor to assess the dryness of your eyes. To measure your tear production, a little piece of filter paper is inserted beneath your lower eyelid.

A doctor who specializes in the treatment of eye issues (ophthalmologist) may also use a slit lamp to inspect the surface of your eyes. He or she may apply drops in your eye to make damage to your cornea more visible.


Imaging

The function of your salivary glands can be checked using imaging tests.
  • Sialogram: This specialized X-ray is capable of detecting dye injected into the salivary glands in front of your ears. This test determines how much saliva goes into your mouth.
  • Salivary scintigraphy: This nuclear medicine test includes injecting a radioactive isotope into a vein, which is then tracked for an hour to measure how quickly it enters all of your salivary glands.

Biopsy

Your doctor may also do a lip biopsy to look for clumps of inflammatory cells, which can suggest Sjogren's syndrome. A sliver of tissue is extracted from the salivary glands in your lip and examined under a microscope for this test.


WHAT ARE THE TREATMENTS FOR SJOGREN'S SYNDROME?

Sjogren's syndrome treatment is dependent on the sections of the body affected. Many people treat Sjogren's syndrome's dry eye and dry mouth by using over-the-counter eyedrops and drinking more water. Some people, however, require prescription drugs or even surgical treatments.

Medications

Depending on your symptoms, your doctor may recommend the following medications:
  • Reduce inflammation in the eyes: If you have moderate to severe dry eyes, your eye doctor may offer prescription eyedrops such as cyclosporine (Restasis) or lifitegrast (Xiidra).
  • Increase saliva production: Saliva and tears can be increased by drugs such as pilocarpine (Salagen) and cevimeline (Evoxac). Sweating, stomach discomfort, flushing, and increased urination are all possible side effects.
  • Address particular issues: If you develop arthritic symptoms, nonsteroidal anti-inflammatory medicines (NSAIDs) or other arthritis treatments may help. Antifungal drugs should be used to treat yeast infections in the mouth.
  • Treat symptoms throughout the system: Hydroxychloroquine (Plaquenil), a malaria treatment, is frequently beneficial in the treatment of Sjogren's syndrome. Immunosuppressive medications, such as methotrexate (Trexall), may also be administered.

Surgery

Punctal occlusion, a simple operation that seals the tear ducts that drain tears from your eyes, may help treat dry eyes. To help protect your tears, collagen or silicone plugs are put into the ducts.


HOME REMEDIES FOR SJOGREN'S SYNDROME

Many Sjogren's syndrome symptoms improve with self-care.

To alleviate dry eyes: 
  • Make use of artificial tears, eye lubrication, or both: Artificial tears and ocular lubricants (in eyedrop, gel, or ointment form) can assist ease the pain of dry eyes. Eye lubricants do not need to be used as frequently as artificial tears. Because of their thicker consistency, eye lubricants might impair your eyesight and gather on your eyelashes, so only use them at night.
Your doctor may advise you to use artificial tears without preservatives, which might irritate the eyes of persons suffering from dry eye syndrome.
  • Increase the humidity: Increasing the humidity in your home and limiting your exposure to blowing air will help protect your eyes and mouth from becoming too dry. Avoid sitting in front of a fan or air conditioning vent, and while going outside, wear goggles or protective eyewear.
To alleviate dry mouth:
  • Don't smoke: Tobacco use can irritate and dry up your mouth.
  • Increase your fluid consumption: Drink plenty of fluids, especially water, throughout the day. Drinking coffee or alcohol might aggravate dry mouth symptoms. Avoid acidic beverages such as colas and other sports drinks since the acid can damage your teeth's enamel.
  • Encourage the flow of saliva: Saliva flow can be increased by chewing sugarless gum or eating citrus-flavored hard candies. Limit sweets, especially between meals, because Sjogren's disease raises your risk of dental cavities.
  • Try artificial saliva: Because they contain a lubricant that keeps your mouth wet for longer, saliva replacement solutions frequently function better than simple water. These items are available as a spray or a lozenge.
  • Use saline nasal spray: A nasal saline spray can assist to moisturize and cleanse nasal passages, allowing you to breathe easily through your nose. A congested nose might cause more mouth breathing.

Oral health

Dry mouth raises your chances of getting cavities and losing teeth. To aid in the prevention of such issues:
  • Brush and floss your teeth after each meal.
  • Make frequent dental appointments, at least once a year.
  • Use topical fluoride treatments and antibacterial mouthwashes on a regular basis.

Other dry areas

If you have dry skin, avoid bathing and showering in hot water. Apply moisturizer when your skin is still damp, patting it with a towel rather of rubbing it. When doing dishes or cleaning the house, use rubber gloves. Women suffering from vaginal dryness might benefit from vaginal moisturizers and lubricants.

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