Sjogren's syndrome

Sjogren's syndrome is a chronic autoimmune disease that primarily affects your moisture-producing glands and causes extensive dryness throughout the body. It often accompanies other autoimmune disorders but can develop on its own.

Our rheumatologists work closely with you and your primary doctor to help you manage Sjogren's syndrome with the latest treatments.

What causes Sjogren's syndrome?

Scientists aren’t sure what causes autoimmune diseases, including Sjogren's syndrome. However, a common link is an overactive immune system due to genetic and environmental factors.

Your immune system, which normally protects your body against harmful invaders such as viruses and bacteria, starts attacking your own body’s cells. If you have Sjogren's syndrome, it attacks your moisture-producing glands.

Sjogren's syndrome symptoms

The symptoms of Sjogren's syndrome can vary from person to person, but the most noticeable symptoms are extensive dryness, particularly in the eyes and mouth.

Common symptoms include:

• Dry eyes: Your eyes may not produce enough tears to stay properly lubricated. You might also feel a gritty or burning sensation, have blurred vision or have a sensitivity to light.
• Dry mouth: You might have a feeling of dryness or stickiness in your mouth. This may be accompanied by difficulty swallowing, speaking or tasting food.
• Vaginal dryness: You may feel discomfort or pain during sexual activity or have an increased risk of vaginal infections.
• Joint pain and stiffness: You may notice arthritis-like symptoms in your joints. This is a common symptom of other autoimmune diseases.
• Swelling of the salivary glands: You may experience swelling, particularly in the area between your jaw and ears.
• Skin rashes or dry skin: Rashes and dry skin may occur due to your body’s inability to retain moisture.
• Digestive problems: You may have acid reflux, stomach pain, diarrhea and constipation, which are common symptoms of Sjogren's syndrome.

Who is at risk for developing Sjogren's syndrome?

Several factors can increase your risk of developing Sjogren's syndrome. Understanding these risks can help you and your health care provider manage your health proactively.

Risk factors include:

• Sex assigned at birth: Females are nine times more likely than males to develop Sjogren's syndrome.
• Age: The condition is typically diagnosed in people over 40, though it can occur at any age.
• Family history: A family history of autoimmune diseases increases your risk.
• Having other autoimmune diseases: Most people who have one autoimmune disease are more likely to develop another. Having another autoimmune condition increases the likelihood of developing Sjogren's syndrome.

Does Sjogren's syndrome get progressively worse?

Sjogren's syndrome is a chronic condition, and its progression can differ by person. For some, symptoms remain mild and manageable. For others, symptoms become more severe over time, affecting more parts of the body.

Potential complications include:

• Infections: The dryness caused by Sjogren's can lead to increased susceptibility to infections, particularly in the eyes and mouth.
• Dental issues: Chronic dry mouth can lead to a higher number of cavities and oral infections.
• Organ impact: In rare cases, Sjogren's can impact the kidneys, lungs or liver.

Sjogren's syndrome diagnosis

Diagnosing Sjogren's syndrome can be challenging due to its wide range of symptoms that overlap with other conditions. Your doctor will ask about your symptoms, including the extent and duration of dryness, and any family history of autoimmune diseases.

They may order blood tests to check for specific antibodies associated with Sjogren's syndrome, such as anti-SSA/Ro and anti-SSB/La.

Other tests may include:

• Eye tests: Tests like the Schirmer’s test measure tear production, while a slit-lamp exam checks for eye dryness and damage.
• Salivary gland tests: These types of tests measure the flow of saliva, and a biopsy of the salivary glands may be performed to check for inflammation.

Treatments for Sjogren's syndrome

While there’s no cure for Sjogren's syndrome, treatment focuses on managing symptoms and slowing down the disease’s progression. Treatment options include:

• Medications: Medications, such as artificial tears for dry eyes or saliva substitutes for dry mouth, can help you manage dryness. In some cases, drugs that suppress the immune system, such as hydroxychloroquine or methotrexate, may be prescribed.
• Lifestyle changes: Staying hydrated, using a humidifier and avoiding smoking or exposure to dry environments can help you manage symptoms.
• Regular checkups: Monitoring for potential complications, such as infections or organ involvement, is crucial.
• Specialized care: If Sjogren's syndrome affects your organs, such as your lungs or kidneys, you may need to see specialists for targeted treatment.

What happens if Sjogren's syndrome goes untreated?

If Sjogren’s syndrome goes untreated, symptoms can get worse over time and cause complications. The most common issues include severe dry eyes and dry mouth, which can cause discomfort, eye infections, corneal ulcers, dental problems like cavities and gum disease, and an increased risk of oral infections.

As the disease progresses, it can also affect other organs, leading to lung problems, kidney issues and liver complications. In some cases, untreated Sjogren’s syndrome can increase the risk of developing lymphoma, a type of cancer.

For these reasons, it’s crucial to see a rheumatologist and follow a treatment plan to manage symptoms and prevent complications. Regular monitoring and adjustments in treatment can help maintain your health.

Living with Sjogren's syndrome

Living with Sjogren's syndrome requires a proactive approach to managing symptoms and maintaining your overall health. While the condition can present daily challenges, people with Sjogren's syndrome can lead fulfilling lives by adapting their routines and following their treatment plans.

Here are tips for managing Sjogren's syndrome:

• Stay hydrated: Drink plenty of water throughout the day to help alleviate dry mouth.
• Protect your eyes: Use lubricating eye drops and wear sunglasses to protect your eyes from wind and bright light.
• Oral care: Practice good oral hygiene to prevent cavities and infections and visit your dentist regularly.
• Manage fatigue: Balance activity with rest and consider gentle exercise to boost energy levels.
• Seek support: Palliative care can be useful for people with chronic illness such as Sjogren's syndrome. Joining a support group or connecting with others who have it can provide additional support and practical advice.