Sjogren’s Syndrome

Sjogren’s syndrome is an auto immune disease. This means that your immune system mistakenly attacks parts of your own body. In Sjogren’s syndrome, the disease attacks the glands that make tears and saliva. This causes a dry mouth and dry eyes. You may have dryness in other places that need moisture, such as your nose, throat, and skin. Sjogren’s can also affect other parts of the body, including your joints, lungs, kidneys, blood vessels, digestive organs, and nerves.

Symptoms

The two main symptoms of Sjogren’s syndrome are:

  • Dry eyes. Your eyes might burn, itch or feel gritty — as if there’s sand in them.
  • Dry mouth. Your mouth might feel like it’s full of cotton, making it difficult to swallow or speak.

Some people with Sjogren’s syndrome also have one or more of the following:

  • Joint pain, swelling and stiffness
  • Swollen salivary glands —in particular the glands located behind your jaw and in front of your ears
  • Skin rashes or very dry skin
  • Vaginal dryness
  • Persistent dry cough
  • Prolonged fatigue

Causes

Scientists and doctors aren’t certain why some people develop Sjogren’s syndrome. Certain genes can put some people at higher risk of the disorder, but it appears that a triggering mechanism — such as infection with a particular virus or strain of bacteria — is also necessary to cause Sjogren’s Syndrome to manifest.

In Sjogren’s syndrome, your immune system first targets the glands that make tears and saliva. But it can also damage other parts of your body, such as:

  • Joints
  • Thyroid
  • Kidneys
  • Liver
  • Lungs
  • Skin
  • Nerves

Risk factors

Sjogren’s Syndrome will typically occur in people with one or more of these known risk factors, including:

  • Age. Sjogren’s syndrome is usually diagnosed in people older than 40.
  • Sex. Women are much more likely to have Sjogren’s syndrome.
  • Rheumatic disease. It’s common for people who have Sjogren’s Syndrome to also have a rheumatic disease — such as Rheumatoid Arthritis or Lupus.

Complications

The most common complications of Sjogren’s syndrome involve your eyes and mouth.

  • Dental cavities. Because saliva helps protect the teeth from the bacteria that cause cavities, you’re more prone to developing cavities if your mouth is dry.
  • Yeast infections. People with Sjogren’s syndrome are much more likely to develop oral thrush, a yeast infection in the mouth.
  • Vision problems. Dry eyes can lead to light sensitivity, blurred vision and corneal damage.

Less common complications might affect:

  • Lungs, kidneys or liver. Inflammation may cause Pneumonia, Bronchitis or other problems in your lungs; lead to problems with kidney function; and cause Hepatitis or Cirrhosis in your liver.
  • Lymph nodes. A small percentage of people with Sjogren’s Syndrome develop cancer of the lymph nodes (Lymphoma).
  • Nerves. You may develop numbness, tingling and burning in your hands and feet (peripheral neuropathy).

Treatment

  • Medications to stimulate saliva flow: These include pilocarpine and cevimeline. They have a short-term impact, limited to a few hours only, so several doses a day are usually required.
  • Artificial saliva: Saliva substitutes and mouth-coating gels can relieve dryness of the mouth. They are available as sprays, pre-treated swabs, and liquids. These can be important at night, as the mouth becomes dryer during sleep.
  • Artificial tears: Artificial tears can help to lubricate the eyes, and are available over-the-counter (OTC). Prescription options are available that reduce the need for artificial tears, such as cyclosporine ophthalmic emulsion and hydroxypropyl cellulose pellets.
  • Prescription eye drops: These include cyclosporine and lifitegrast.
  • Moisture chamber spectacles: These are special glasses that keep out irritations like dust.
  • Prescription expectorants and throat medications: In cases of respiratory dryness, drugs such as those used to stimulate saliva flow, as well as linseed extract, sorbitol, xylitol, or malic acid, can moisturize the area.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Anti-inflammatory drugs such as Aspirin and ibuprofen can provide relief for people with Sjogren’s who are experiencing joint pain.
  • Disease-modifying antirheumatic drugs (DMARDs): In cases where the joint pain is accompanied by fatigue and rashes, DMARDs may relieve symptoms. Examples include hydroxychloroquine or methotrexate. If Sjogren’s seems to be affecting the muscles, nerves, lungs, or kidneys, stronger DMARDs, corticosteroids, or rituximab may be prescribed.
  • Antifungal medication: If oral yeast infections are occurring, medication may be prescribed to combat the fungus.
  • Vaginal lubricants: For vaginal dryness, water-based vaginal lubricants can provide a solution, especially during sexual intercourse.
  • Punctual occlusion: When all conservative treatment options have been exhausted, this surgical option seals the tear ducts with small plugs to reduce the drainage of tears from the eye. This keeps the eye moist for longer. Temporary silicone plugs are likely to be used until the procedure is confirmed successful.
  • Autologous eye serum: In severe cases of eye dryness, eye drops can be made from the person’s blood serum.

Ideas to Ease Sjogren’s Syndrome

Here are some easy ways to keep the mouth lubricated.

  • consuming more liquids.
  • rinsing the mouth regularly to prevent infection and soothe the area
  • maintaining excellent oral and dental hygiene
  • topical fluoride gels or varnish
  • Stop smoking. As smoke irritates the mouth and speeds up the evaporation of saliva
  • chewing sugar-free gum, which stimulates the production of saliva
  • applying a coconut oil to the dry area as a moisturizer and fo an anti-microbial treatment.

Credits

https://medlineplus.gov/sjogrenssyndrome.html

https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/symptoms-causes/syc-20353216

https://www.medicalnewstoday.com/articles/233747#treatment