Sjogren'S Syndrome

Sjogren’s syndrome is a disorder of immune system commonly manifested by two major symptoms- dry eyes and dry mouth.

Sjogren’s syndrome often is seen with other immune system disorders, such as rheumatoid arthritis and lupus.

In sjogren’s syndrome the mucous membranes of our body become dry because the mucous secreting glands are affected and their function is decreased.

Although sjogren’s syndrome develops at any age most of the people older than 40 are diagnosed with sjogren’s syndrome. Mostly known to occur in women. Symptomatic treatment is preffered.

The characteristic symptoms of Sjogren’s syndrome are:

• Dry eyes: Burning sensation in eyes, itching of feeling gritty as there is sand in eyes.
• Dry mouth: Mouth fells like its full of cotton, making it difficult to swallow or speak.

Some people with sjogren’s syndrome also experience the following symptoms:

• Joint pain,
• swelling and stiffness,
• swollen salivary glands,
• skin rashes or dry skin,
• vaginal dryness,
• persistent dry cough,
• prolonged fatigue. 

The exact cause of Sjogren's syndrome is not known.

Sjogren’s syndrome is an auto immune disorder. In this kind of disorder our body’s immune system attacks our own cells and tissues leading to their damage and dysfunction.

Scientists aren’t sure the exact reason for this aggression of immune cells.

Certain genes put people at higher risk, it appears that a triggering mechanism such as infection with a particular virus or strain of bacteria is also necessary.

In sjogren’s syndrome immune system first targets the secreting glands of our body especially in mouth and eye. But it can also damage other parts of the body such as:

• joints,
• lungs,
• kidney,
• liver,
• nerves,
• thyroid,
• skin.

Sjorgen’s syndrome is difficult to diagnose because signs and symptoms vary from person to person and can be similar to those caused by other diseases.

Side effects of different medications also mimic this situation.

The following tests will help to rule out probabilities and diagnose the syndrome:

• Blood test: CBC (common blood count) number of different cells present in blood, presence of antibodies, evidence of inflammatory conditions, problems with liver and kidney.
• Eye test: Doctor will measure dryness of eyes with a test called schirmer tear test. Small piece of filter paper is placed on lower eyelid to measure tear production. Slit lamp can also be used to examine the surface of eye.
• Imaging: Certain imaging tests can check function of glands.
• Sialogram A special x-ray called sialogram can detect dye that is injected into salivary glands located in front of ears. This procedure determines the amount of saliva flowing into the mouth.
• Salivary scintigraphy: This nuclear medicine teat involves the intravenous injection of a radioactive isotope, which is tracked to see how quickly it arrives the salivary glands.
• Biopsy: Biopsy can be performed to indicate the presence of inflammatory cells. 

Most of the symptoms caused by Sjogren’s syndrome can be handled easily by over the counter eye drops and drinking more water but some people may need treatment.

Medications include:

• Increasing production of saliva: Drugs such as pilocarpine and cevimeline can increase the production of saliva.
• Dress specific complications: Inflammation in joints can be cured by NSAIDs and other arthritis medications. Oral candidiasis must be treated with anti-fungal drugs.
• Treat systemic symptoms: Hydroxyxhoroquine, a drug which can treat malaria, is helpful in dealing with sjogren’s syndrome.

Surgery

To relive symptom of eye dryness one might just undergo surgical procedure which seals the tear ducts and drain tears. As an alternative doctor might also use laser to seal the tear ducts. 

The exact cause of sjogren’s syndrome is unknown, this is the reason prevention becomes difficult.

No known preventive measures exist for autoimmune diseases. 

A few alternative and homeopathic remedies exist for Sjogren's syndrome. These include:

• Artificial tears, an eye lubricant: Artificial tears (in eye drop form) eye lubricants (eye drops, gel, ointment form) can help relieve the symptoms of dryness in the eyes.
• Increase humidity: Increasing the indoor humidity and reducing exposure to blowing air may help from getting eyes dry.
• Increase fluid intake: Drinking lots of fluids, particularly water helps reduce symptoms of dry mouth.
• Stimulate saliva flow: Sugarless gum or hard candies can boost saliva flow. Because sjogren’s syndrome increases risk of dental cavities. Lemon juice can also help secrete saliva.
• Try artificial saliva: Saliva replacement products often work better than plain water because they contain lubricant which helps to keep mouth moist for longer period of time.
• Nasal saline spray: A nasal saline spray can help moisturize and clear nasal passages and makes nose breathing easy. Avoid hot water to bath if dryness persists in skin. Pat skin doesn’t rub with a towel and apply moisturizer when skin feels damp. Vaginal moisturizers and lubricants are available in case of vaginal dryness.

There will be no significant changes in lifestyle of people with sjogren’s syndrome.

Drinking more fluids and regular usage of eye drops will improve the quality of life.

Regular consultation with doctor is recommended for better coping. 

There are several risks and complications associated with Sjogren's syndrome.

Although anyone can develop sjogren’s syndrome, it typically occurs in people with one or more known risk factors.

They include:

• Age: Sjorgen’s syndrome is usually diagnosed in people over the age of 40 years.
• Sex: Women are much more likely to have sjorgen’s syndrome.
• Rheumatic disease: It is commonly seen that in people with sjogren’s syndrome rheumatic diseases like rheumatoid arthritis and lupus are noticed.

Complications of this disease depend on the organ affected dental cavities - because saliva helps protect teeth from bacteria which causes cavities hypo secretion of saliva leads to development of dental cavities. Complications include:

• Yeast infections: Oral thrush is commonly seen in people with sjogren’s syndrome.
• Vision problems: Dry eyes can lead to light sensitivity, blurred vision and corneal ulcers.

Less common complications are:

• Lungs: kidney or liver inflammation may lead to pneumonia, bronchitis and other problems in lungs.
• Hepatitis and cirrhosis of liver can be seen with problem in liver.
• Kidney failure can also be noticed in problem with kidney.
• Lymph nodes: A small percent of people with sjogren’s syndrome develop cancer of lymph nodes.
• Nerves: Numbness, tingling, and burning in hands and feet (peripheral neuropathy).