Sjogren's syndrome is an autoimmune disease where the immune system attacks its own body. In Sjogren's syndrome, it attacks the glands that make tears and saliva which causes symptoms of a dry mouth and dry eyes. There may also be dryness in other places that need moisture, such as your nose, throat, and skin. Other parts of the body, including the joints, lungs, kidneys, blood vessels, digestive organs, and nerves may also be affected.

Sjogren's syndrome usually affects women over the age of 40. It is sometimes co-exisitng to other diseases such as rheumatoid arthritis and lupus.

 
 

The main symptoms of Sjorgen's syndrome are dry mouth and dry eyes however the following other symptoms may also be experienced

  • Joint pain, swelling and stiffness

  • Swollen salivary glands — particularly the set located behind your jaw and in front of your ears

  • Skin rashes or dry skin

  • Vaginal dryness

  • Persistent dry cough

  • Prolonged fatigue

Note: Always seek advice from a doctor before beginning any listed treatments. Treatments can affect everyone differently.

Dry Eyes & Mouth

Medical Treatments

Artificial tears for Sjogrens:

There are various types of eye drops, so the patient can try different brands to find the one that works best for them. If using eye drops regularly (more than three times a day), one should use one that doesn't contain preservatives because over-exposure to preservatives can damage the surface of the eye.

Corticosteroid eye drops for Sjogrens:

A short-term dose of eye drops containing corticosteroids may be prescribed if the eyes become irritated. Long-term corticosteroid use isn't recommended because they can cause serious side effects.

Moisture chamber spectacles for Sjogrens:

Wearing these special glasses reduces tear evaporation by up to 30%. These wrap around the eyes like goggles and help retain moisture and protect the eyes from irritants.

Punctal Plugs for Sjogrens:

seals the tear ducts (into which the tears drain) with small plugs. This should help keep the eye better protected by tears. Temporary plugs made of silicone are generally first used to see if they help. If they do, more permanent plugs can be used.

Mouth care for Sjogrens:

Techniques to keep the mouth lubricated include

  • maintaining good oral hygiene by brushing and flossing to prevent tooth decay and gum disease

  • increasing your daily fluid intake

  • sugar-free chewing gum can help stimulate saliva production

  • sucking ice cubes to help lubricate the mouth and reduce dryness

  • mouth rinses may soothe the mouth and help protect it against infection

  • quit smoking as it irritates the mouth and increases the rate at which saliva evaporates.

Saliva substitutes for Sjogrens:

such as sprays, lozenges (medicated sweet), gels, or gum products can help lubricate the mouth. They don't replicate the role of saliva in preventing infection, so it is important to maintain excellent oral hygiene.

Pilocarpine for Sjogrens:

is a medication used to help dry eyes and mouth. It works by stimulating the glands to produce more saliva and tears. Side effects may outweigh the benefits so discuss with your doctor.

Hydroxychloroquine for Sjogrens:

is a medication that works by slowing down the immune system's attack on the tear and saliva glands. It can also help reduce any associated symptoms of muscle pain, joint pain and stiffness. It can take up to several months to start working. Discuss with your doctor.

Professional Support:

Working with a trained practitioner can assist you to develop skills to calm anxiety and can also equip you with knowledge to find your next steps towards wellness. Please ensure that you find a practitioner who understands how to navigate the territory of complex chronic health conditions.

Alternative Treatments

Nose breathing for Sjogrens: 

when breathing through your nose the air is warmed and dampened before reaching your throat. Mouth-breathing also causes excessive evaporation of the moisture in your mouth.

Omega-3 oils for Sjogrens:

found in oily fish like salmon, mackerel, sardines and fresh tuna as well as flaxseed oil and canola oil, may increase tear production and tear volume. Excessive intake of omega-3 fatty acids are not
recommended for people who are taking blood-thinning medications.

Castor oil eye drops for Sjogrens:

may help patients with dry eyes. Do not use castor oil for dry eyes if you are pregnant.

Warm compresses for Sjogrens:

Using a warm, moist compress over closed eyes, may improve tear production and increase the thickness of the tear film, moistening dry eyes.

N-Acetyl-L cysteine for Sjogrens:

is a supplement which may assist Sjogren’s sufferers by helping the body produce antioxidants as well as by combating symptoms of dry eyes and dry mouth. Discuss with your doctor before beginning, especially if diabetic.

Collagen and Keratin Tablets for Sjogrens:

It is also thought to help loosen secretions, and for this reason it has been tried as a treatment for Sjogren’s syndrome

Betaine toothpaste for Sjogrens:

a detergent free toothpaste that may help with dry mouth symptoms. Betaine is a substance produced by your body to aid in liver function.

Mindfulness for Sjogrens:

is an ancient meditation technique used to help patients suffering from complex chronic illnesses. Mindfulness is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. For more info click here.

 

Dry Skin & Vaginal Dryness

In addition to the above listed treatments for dry eyes and dry mouth, the following treatments may also help relieve dryness in other bodily regions.

Special soaps and creams:

dedicated to patients with dry skin are available to help with this condition. Discuss with either your doctor or chemist.

Oestrogen creams or hormone replacement therapy (HRT):

Are options available to women who suffer from vaginal dryness. Discuss with your doctor.

 

 

 

Muscle and Joint Pain

 

if joint pain or arthritic pains develop, relief may be found from nonsteroidal anti-inflammatory drugs (NSAIDs) or other arthritis medications. More information on medications and alternative solutions here

 

Blood Tests: help diagnosis Sjogren's by looking for antibodies known as anti-Ro and anti-La (or SS-A and SS-B), which are produced when the immune system has been affected by Sjögren's syndrome. These antibodies are only present in about 60% of patients with Sjögren’s syndrome. Other useful blood tests include

  • Levels of different types of blood cells

  • Evidence of inflammatory conditions

  • Indications of liver and kidney problems

Tear break-up time and Schirmer tests: are performed by an ophthalmologist (an eye conditions specialist).

  • The tear break-up time test measures how effective the tear glands are. A non-toxic dye is dropped onto the surface of the eye and the colour of the dye allows the specialist to see how well the tear film is functioning and how long it takes for tears to evaporate. The specialist may also use a special microscope slit lamp to examine the tear glands more closely.

  • With the Schirmer tear test, a small piece of filter paper is placed under the lower eyelid to measure tear production. After five minutes, the strips are removed to see how much of the paper is soaked with tears.

Lip Biopsy: a small tissue sample is removed from the inner lip and examined under a microscope. Clusters of lymphocytes (a type of white blood cell) in the tissue can indicate Sjögren's syndrome.

Imaging tests: can check the function of the salivary glands.

  • Sialogram: is an X-ray that can detect dye that's injected into the salivary glands located in front of the ears. This special X-ray shows how much saliva flows into the mouth.

  • Salivary scintigraphy: is a test where radioactive isotope is intravenously injected and then tracked over the course of an hour to see how quickly it arrives to all of the salivary glands.

Salivary flow rate: A salivary flow rate test measures how much saliva your glands produce. The patient spits as much saliva as they can into a cup over a five-minute period. An unusually low flow rate can indicate Sjögren's syndrome

Which medications or supportive therapies have helped your Sjogren's Syndrome?

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Disclaimer: Information and advice shared by Chronic Health Info is of a general nature and is not intended to replace qualified medical advice.

The Towards Wellness Centre does not accept responsibility for any actions or treatments undertaken.