Sjogren’s Syndrome

Dr. Henrik Sjogren (show-gren), a Swedish Optalmologist first described a group of women with dry eyes, dry mouth and systemic complaints.

Today Sjogren’s Syndrome is known to be an autoimmune disease causing inflammation in varies areas of the body, but often affecting the exocrine glands that produce tears and saliva.

Patients with this disorder will often complain of dry eyes and dry mouth.  Some patents will also note more diffuse dryness symptoms with dryness in the nose, throat, vagina and skin.

Primary vs. Secondary Sjogren’s Syndrome

Sjogren’s syndrome is classified as either primary or secondary. The “Primary” form occurs in people with no other rheumatologic disease. The “Secondary” form occurs in people who already have another rheumatologic disease, most commonly rheumatoid arthritis or systemic lupus erythematosus.

Symptoms Of Sjogren’s Syndrome

Dry Mouth: Poor saliva production can cause symptoms of dry mouth but can also lead to dental decay, gingivitis, oral yeast infection (thrush).

Dry Eyes: Poor tear production can  cause a gritty sensation in the eye along with burning and irritation. Patient’s with dry eyes should see an Opthalmologist to help treat symptoms as well as monitor for infection or signs of damage to the cornea.

Systemic Inflammation: Complications from Sjogren’s Syndrome can also affect other parts of the body including:

• Joint inflammation or muscle pain
• Skin rashes
• Lung inflammation that can mimic pneumonia
• Neurologic problems that can cause numbness or tingling in the extremities

How is Sjogren’s Syndrome Diagnosed?

Since the symptoms of Sjogren’s Syndrome can be non-specific a proper diagnosis depends on discussing current symptoms, physical examination, and a series of blood tests. A comprehensive eye exam is often helpful in establishing a diagnosis. On occasion a biopsy of the salivary gland or parotid gland may be necessary to make a correct diagnosis. A Rheumatology evaluation is often needed to confirm the diagnosis.

Treatment of Sjogren ’s Syndrome

There is no one global treatment for Sjogren’s Syndrome. Efforts are made to lessen any active symptoms and improve quality of life. Prescription medication may be required, but many of the daily symptoms of dryness can be treated with over the counter products.

Dry Eyes – The initial treatment is to use eye drops in form of artificial tears to provide moisture to the eyes. We recommend obtaining single-dose packages to prevent contamination of the fluid and using a preservative-free tear which is less likely to cause eye irritation. Protect your eyes from wind, sun and sand. Use humidifiers in rooms you spend most of your time. Avoid exposure to eye irritants such as tobacco smoke.  Prescription eye drops and plugging of the tear ducts (punctual occlusion) are options for more severe cases of dry eye. It is important to obtain regular eye care with an Ophthalmologist.

Dry Mouth – There are many non-prescription therapies which patients find helpful. Sipping on water or sugar free drinks during the day improves sensation of dryness, chewing sugarless gums or candies to stimulate salivary flow, over the counter saliva substitutes and oral rinses. Prescription medications are available for more severe cases.  It is imperative to practice good oral hygiene to prevent tooth decay and oral infections.  See your dentist on a regular basis for evaluations and guidance in your oral hygiene needs.

Medications Contributing to Dryness

Be aware that certain medications contribute to dry eyes and dry mouth including:

• Antihistamines
• Antidepressant medications
• Diuretics
• Decongestants
• Some blood pressure medications