Sjogren’s syndrome is an autoimmune condition that can cause symptoms throughout the body. These symptoms include dry eye and dry mouth.

Sjorgren’s syndrome happens when white blood cells infiltrate saliva glands, tear glands, and other exocrine tissues, decreasing tear and saliva production. This can cause dryness in the mouth, eyes, skin, nose, upper respiratory tract, and vagina.

Primary Sjogren’s syndrome develops alone, but secondary Sjogren’s syndrome co-occurs with another condition, such as lupus. The symptoms are similar, and both can be severe.

Sjogren’s syndrome is a serious condition. However, timely treatment can mean that complications are less likely to develop, and tissue damage is less likely to occur.

This article further explained Sjogren’s syndrome. It also discusses the symptoms, causes, and treatment for the condition.

Fast facts about Sjogren’s syndrome

  • Sjogren’s syndrome is an autoimmune disorder that affects moisture-producing glands.
  • The condition affects 0.1-1% of the population, and 90% of people with Sjogren’s syndrome are females.
  • It causes dry eyes and mouth, leading to tooth decay, recurring oral thrush, and a persistent dry cough.
  • Sjogren’s syndrome affects multiple systems and can be difficult to diagnose. However, blood tests, ophthalmological testing, and measuring the salivary flow rate can help identify the condition. A biopsy of the lower lip can also be important in the diagnosis.
  • Prescribed eye drops, artificial tears, and moisture chamber spectacles can help to relieve dry eyes.
  • Other medications can help to stimulate the flow of saliva. Chewing sugar-free gum can help lubricate the mouth, and numerous saliva substitutes are available to try.
Was this helpful?
Female in a blue light with a red line across her faceShare on Pinterest
Marco_Piunti/Getty Images

Sjogren’s syndrome is an autoimmune condition. This means it is part of a group of conditions that occur when the immune system attacks the body’s own tissues and organs. In Sjogren’s syndrome, this means the immune system focuses on the glands that produce tears and the ones that produce saliva. This leads to dry eyes and dry mouth.

Most of the time, Sjogren’s syndrome does not affect a person’s overall health or life expectancy. However, the immune system can sometimes attack other tissues or organs, leading to complications. This included inflammation of connective tissues, joints, and muscles. When this occurs these conditions are known as rheumatic conditions. They include rheumatoid arthritis and lupus.

There are two types of Sjogren’s syndrome:

  • Primary form: This is when Sjogren’s syndrome occurs on its own with no presence of other conditions.
  • Secondary form: This is when Sjogren’s syndrome occurs with other rheumatic conditions.

Sjogren’s syndrome can develop at any age, but most diagnoses occur after the age of 40 years. 90% of cases occur in females. However, it also affects and can be under-diagnosed, in males. It affects around 0.1-1% of the population.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?

The most common symptoms of Sjogren’s syndrome are dry eyes and dry mouth. Some people may experience only one of these. However, they can also occur together.

Dry eye symptoms may include:

  • burning or itching sensation
  • gritty feeling
  • blurry vision
  • light sensitivity
  • irritation, itchiness, and inflammation of the eyelids

Dry mouth symptoms may include:

  • chalky feeling
  • difficulty swallowing, tasting, or speaking
  • tooth decay, such as cavities
  • mouth infections, such as oral thrush

Smoking, air travel, overhead fans, and air-conditioned or windy environments can exacerbate symptoms.

Sjogren’s syndrome can affect other tissues and organs. This can lead to more widespread effects on the body. Other symptoms include:

  • dry skin
  • joint pain
  • fatigue
  • dry nasal passages and throat
  • persistent dry cough
  • acid reflux
  • muscle aches
  • skin rashes
  • swollen glands around the neck and face
  • vaginal dryness
  • difficulty concentrating and memory issues
  • difficulty sleeping
  • shortness of breath
  • muscle weakness
  • numbness and tingling, especially in the arms and legs

Some people may also experience:

The causes of Sjogren’s remain largely unknown.

However, researchers believe a viral or bacterial infection may trigger the condition, but that the underlying cause is primarily genetic and environmental.

As the majority of people who develop Sjogren’s are female, one theory is that estrogen, a female hormone, plays an important role. However, this is still not understood.

Some studies theorize that estrogen protects against Sjogren’s syndrome, and falling levels of the hormone may alter immune function and trigger the condition. This means a major risk factor for Sjogren’s syndrome is menopause.

Sjogren’s treatment aims to lubricate the affected areas and prevent the onset of complications.

Treatment options include:

  • 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 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 irritants and retain moisture.
  • 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, naproxen, 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 thrush occurs, 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.

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
  • quitting smoking, as smoke irritates the mouth and speeds up the evaporation of saliva
  • chewing sugar-free gum, which stimulates the production of saliva
  • applying coconut oil to the dry areas, as it is both moisturizing and anti-microbial

Diet

There is no specific diet for Sjogren’s syndrome.

Alcohol should be avoided, however. People may also wish to avoid foods that irritate the mouth, such as spicy or acidic items.

Sugar-free lozenges (xylitol) may help keep the mouth moist.

To help with dry mouth symptoms, an individual can try the following tips:

  • eat soft, moist foods with plenty of sauce
  • have a drink alongside your food, using liquids can help increase food taste
  • avoid carbonated drinks, spicy, and acidic foods
  • increase fluid intake

Keeping a food diary may help pinpoint any specific foods that may cause a reaction or worsen sympto

As Sjogren’s syndrome signs and symptoms are similar to other health conditions, it can sometimes be difficult to diagnose. An individual may see various healthcare professionals. This may include a dentist for dry mouth and tooth decay, a gynecologist for vaginal dryness, and an ophthalmologist for dry eyes, a pulmonologist for shortness of breath and chronic cough.

Some medications can also cause symptoms similar to those in Sjogren’s syndrome.

Tests

Sjogren’s syndrome presents in different ways for different people. A healthcare professional may order tests, including:

  • Blood tests: Sjogren’s syndrome triggers the presence of special antibodies in the blood. These antibodies show up in about 40-70% of people with Sjogren’s syndrome. However, they can also be present in people with lupus.
  • Ophthalmological tests: An ophthalmologist can perform the Rose Bengal, Lissamine green, and Schirmer eye tests. They use dyes and blotting paper to expose dry areas on the eye.
  • Salivary flow rate: The healthcare professional measures the weight of saliva produced in a cup over 5 minutes. If insufficient saliva is produced, this may indicate Sjogren’s.
  • Sialogram: A healthcare professional injects a dye into the parotid glands. An X-ray is then taken to determine how much saliva flows into the person’s mouth. Healthcare professionals are using this test less, however.
  • Salivary scintigraphy: A radioactive isotope is injected and tracked with imaging to measure salivary gland function.
  • Chest X-ray or CT-scan: This determines the presence of inflammation in the lungs, which can be caused by Sjogren’s.
  • Skin biopsy with nerve fiber stain: This determines the presence of small fiber neuropathy (SFN).
  • Urine testing: Urine is sampled and tested to determine whether the kidneys have been affected.

Sjogren’s syndrome can cause complications, especially if it leads the immune system to attack other tissues and organs. These include:

It is important to seek treatment for Sjogren’s syndrome quickly in order to reduce the risk of complications.

Rash

People with Sjogren’s syndrome may be more susceptible to a rash, especially after spending time in the sun.

Skin problems that occur with the condition may present as:

  • xerosis, or dry, rough skin
  • small “blood spots” or purpura on the lower legs due to vasculitis, or inflammation of the blood vessels
  • vasculitic skin lesions that may appear as welts, lumps, blisters, or ulcers
  • red or discolored, ring-shaped lesions with a pale area in the middle, known as annular erythema

Using a strong moisturizer can help prevent dry skin. If vasculitis occurs, a healthcare professional may prescribe drugs to suppress the immune system, such as cyclophosphamide.

Below are some commonly asked questions about Sjogren’s syndrome .

Is Sjogren’s a form of lupus?

Sjogren’s syndrome is not a form of lupus. However, the condition can occur in association with other autoimmune diseases, most commonly lupus and rheumatoid arthritis. This is known as secondary Sjogren’s syndrome.

What are three signs of Sjogren’s syndrome?

Three signs of Sjogren’s syndrome are:

  1. dry eyes
  2. dry mouth
  3. fatigue

What happens during a Sjogren’s flare?

People with Sjogren syndrome can experience periods of flares, or worsening symptoms, followed by periods of remission.

During a Sjogren’s flare, a person may feel fatigued and have brain fog, joint pain, dry eyes, and dry mouth.

What is the life expectancy of Sjogren’s?

It remains uncertain whether Sjogren’s syndrome results in a reduced life expectancy.

However, those with moderate to severe disease can have a very poor quality of life and symptoms tend to worsen with age. In the long run, there is also a risk that patients with Sjogren syndrome will develop a lymphoproliferative disorder which, in turn, can lower life expectancy.

Sjogren’s syndrome is an autoimmune condition that commonly causes dry eye and mouth. This can lead to issues, such as tooth decay, oral thrush, and blurry vision.

Sjogren’s syndrome can also cause the immune system to attack other tissues and organs. This can lead to issues, such as joint pain, muscle aches, and difficulty concentrating.

Medications can help manage the symptoms of Sjogren’s syndrome. A person who experiences persistent dry eye or dry mouth should contact a healthcare professional.