As with all autoimmune diseases, Sjögren's (show-grins) syndrome is characterized by a malfunctioning immune system that attacks healthy cells and tissue. However, in this condition, the immune system specifically attacks the exocrine glands, which produce saliva and tears. This leads to symptoms of dry mouth, dry eyes, and other issues.
Sjogren's tends to develop gradually. In the early stages, people may notice increased thirst, dry mouth, difficulty swallowing dry foods, excessive eye blinking, or irritation. As the disease worsens, saliva production is drastically reduced, making eating dry, spicy, or crunchy foods painful. Tear production also decreases, causing eyes to feel gritty, bright lights to be bothersome, and corneas at higher risk of abrasion.
While Sjogren's syndrome cannot be cured, medical management has made significant progress in helping patients control symptoms, prevent complications, and maintain a good quality of life and functionality.
What Are The Symptoms of Sjogren's Syndrome?
The hallmark symptoms of Sjogren's syndrome are dryness of the eyes, known as dry eye syndrome, and dryness of the mouth, known as xerostomia. However, Sjogren's impacts the entire body. Other possible symptoms of Sjogren's syndrome include:
Fatigue or low energy. Feeling very tired is a frequent complaint.
Joint pain, swelling, and stiffness. Some experience arthritis-like pain in the joints, typically the small joints of the hands.
Swollen salivary glands. The parotid glands in the cheeks may become swollen, painful, and tender.
Nose and sinuses dryness. Dry nose and nasal passages often lead to frequent nosebleeds.
Vaginal dryness. In some women, lack of moisture in the vaginal walls and tissues can make sexual activity uncomfortable and painful.
What Are The Causes and Risk Factors of Sjogren's Syndrome?
While we don't know exactly why some people develop Sjogren's syndrome and others do not, aging is a clear risk factor. The majority of people with Sjogren's syndrome are over the age of 40 at the time of diagnosis. Being female also increases the risk, as women account for 90% of Sjogren's syndrome cases.
In summary, the primary causes and risk factors for Sjogren's syndrome include:
Genetics - certain HLA genes and family history of autoimmune disease
Viral infections - especially Epstein-Barr virus
Hormonal changes - decreasing estrogen in women
Stress and trauma - severe or prolonged stress can weaken the immune system
Age - most common in people over 40
Sex - 90% of cases are women
How is Sjogren's Syndrome Diagnosed?
Sjogren's syndrome proves tricky to diagnose because its symptoms are subtle and overlap with other conditions. There is no single definitive test for the disease. Instead, doctors rely on a combination of the patient's medical history, symptoms, blood work, eye exams, and sometimes a lip biopsy to determine if Sjogren's is the culprit.
During the evaluation, rheumatologists inquire about symptoms like dry eyes and mouth, joint pain, fatigue, and any relevant medical issues. They also review the patient's personal and family health history for signs of autoimmune disease.
While certain blood tests, like the anti-nuclear antibody test (ANA), anti-Ro/SSA, and rheumatoid factor tests, may detect autoimmune activity and markers linked to Sjogren's syndrome, negative results do not eliminate the possibility of a diagnosis.
Eye exams commonly check for decreased tear production and dry eyes. Measuring tear production with the Schirmer test or staining the eyes to check for dry spots can confirm problems with tear formation and support a Sjogren's diagnosis. Salivary flow rates may also gauge how much saliva is produced over time.
What Are The Treatments for Sjogren's Syndrome?
Though incurable, Sjogren's syndrome can be managed through treatments that reduce symptoms, slow disease progression, and improve quality of life. Several approaches tackle this autoimmune disease, including medications, procedures, and self-care strategies.
Lubricants and oral rinses keep moisture in the eyes and mouth, preventing dryness and tooth decay.
Immunosuppressants like steroids curb inflammation and organ damage.
Newer biologic therapies suppress overactive immune systems.
Severe dry eye cases may use punctal plugs, tarsorrhaphy, or telekinetic lenses to improve vision and ease pain.
Treatment is tailored to each patient based on symptom severity. Combined approaches provide the most benefits. Under a rheumatologist's care, inflammation is controlled, and active life is possible despite this chronic illness.
What Are The Complications and Prognosis of Sjogren's Syndrome?
Sjogren's syndrome can lead to several complications, and the prognosis varies from person to person.
*Common complications include dry eye disease, which can potentially cause damage to the cornea.
*Chronic dry mouth increases the risk of dental cavities and oral infections.
*The dryness of other mucous membranes can make swallowing and digesting food difficult.
*Some patients may develop joint inflammation, swelling, and pain.
*In rare cases, the inflammation may spread to affect other organs like the lungs, kidneys, or nervous system.
The prognosis for most Sjogren's syndrome patients is good, especially if diagnosed and managed early. While no cure exists, treatment focuses on relieving symptoms and reducing complications.
However, a small percentage of patients experience severe disease with life-threatening complications. They may require more aggressive treatment like chemotherapy drugs to suppress the overactive immune system. Hospitalization and surgery may also be needed to manage certain organ or tissue damage.
Sjogren's Syndrome Treatment in Orange County
You don't have to suffer through dry, gritty eyes or difficulty chewing and swallowing. Our compassionate doctors listen carefully and understand the challenges Sjogren's brings. We stay up-to-date with the latest diagnostic techniques and treatment options so we can find an approach to help reduce your discomfort.
At our office in Orange County, we offer attentive, unrushed care. Appointments are available for new patients, and we work closely with your other doctors to coordinate treatment. Don't delay - you can start feeling like yourself again. Call OC Rheumatology & Arthritis today to schedule your appointment and take the first step toward relief and comfort. Our number is 714-825-0891
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