Sjögren’s syndrome, symptoms and treatment

Sjögren’s syndrome is characterized by reduced tear and saliva production. This is the result of inflammation of the tear glands and salivary glands. We are talking about an autoimmune disease here. In a small number of cases, heredity plays a role. It mainly occurs in women over 50 years old. Complaints such as a dry mouth, red and dry eyes, dry skin and inflammation elsewhere in the body are common. In half of the cases there is also rheumatism or a connective tissue disease. In a small number of cases, lymphatic cancer develops.

What is Sjögren’s syndrome?

Sjögren’s syndrome is named after the Swedish ophthalmologist H. Sjögren. This is an autoimmune disease. The immune system starts to see its own tissue as a foreign substance and produces antibodies against it. Normally the immune system clears away the body’s own cells that have become redundant. This is accompanied by no symptoms. With an autoimmune disease, two things can happen:

  • An inflammatory response occurs when the body’s own unnecessary cell debris is cleared away.
  • Well-functioning body cells are cleared away, while this should not be the case.

As a result, damage occurs to the body, often to one organ. Various inflammatory reactions can also occur throughout the body. Sjögren’s syndrome is an autoimmune disease characterized by inflammatory reactions in the tear and salivary glands. This disease often occurs alongside another autoimmune disease.

Symptoms

Because the tear and salivary glands become inflamed, this affects the eyes and mouth. The eyes feel burning and itchy. The feeling as if there is sand in the eyes is more common. The eyes are dry. This has consequences for the cornea. This becomes rough and therefore more sensitive to dust, sunlight and irritants. The cornea is often damaged. The eyes also usually look red. The upper eyelid may swell on the outside.

The mouth is also dry because the salivary glands are inflamed and therefore produce less saliva. This has consequences for oral hygiene. Saliva protects the teeth. With a dry mouth, tooth decay occurs more quickly. The salivary glands may swell. The lips dry out faster and show cracks. Eating can be made difficult by dry mouth. Loss of taste or changes in taste may occur. This can also make talking difficult. During the night, the patient may wake up more often due to a dry mouth and throat. Some patients get a fungal infection in the mouth more often.

In women, the vagina can be dry. Dry skin also occurs in both men and women. In addition, fatigue may occur. Most patients have to deal with this. Some people develop Raynaud’s phenomenon, in which white fingertips quickly turn red/blue. This is also often an autoimmune disease. Inflammation of the thyroid gland, vessels or muscles is also seen. Heartburn often occurs as a result of a dry mouth. High blood pressure and edema (fluid retention) may develop at a later stage. Most complaints worsen over the years or more are added. The quality of life deteriorates moderately to strongly in most patients.

Who does it happen more often to?

It appears that women over the age of 50 are more likely to suffer from Sjögren’s syndrome. In half of all cases, rheumatism or another connective tissue disease occurs in addition to Sjögren’s syndrome.

Malignant lymphoma

When there is no evidence of connective tissue disease, Sjögren’s syndrome carries an increased risk of malignant lymphoma. We also call this lymphatic cancer. About 5 to 8 percent of all patients will be diagnosed with non-Hodgkin lymphoma.

Therapy

There is no medicine that cures the disease. However, symptom relief can be done. It is important to combat dry mouth by drinking plenty of water, especially while eating and talking. In addition, there is so-called artificial saliva. Medications that stimulate the salivary glands to produce saliva can sometimes help. There are artificial tears in the form of eye drops for dry eyes. Eye protection in dry (outdoor) air is recommended.

Inflammations in the body will have to be treated with medication. Patients are often under regular supervision by a doctor. This may be antibiotics, but other medications are also used to combat inflammation or to relieve complaints. Because half of the patients also have rheumatism or another connective tissue disease, referral to a rheumatologist will be necessary. In addition, it is important that the patient lives as healthily as possible:

  • exercise regularly
  • Healthy and responsible food
  • No smoking or drinking (alcohol)

Exercise is especially important for complaints such as rheumatism and arthritis to prevent further stiffness and decalcification. The rehabilitation doctor or physiotherapist can provide advice on this. Fatigue often gets in the way of exercise. Give in to fatigue but try to lead a reasonably active life for as long as possible.

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