Sjogren’s Syndrome – Diagnosis and Treatment
Diagnosis
Blood Analysis
Doctors order blood work to look for signs of autoimmune diseases, including Sjögren’s syndrome. These tests check for antibodies such as ANA (antinuclear antibodies) and RF (rheumatoid factor).
These markers show if the immune system is attacking healthy tissues. Doctors also review blood counts to detect inflammation or related conditions like systemic lupus erythematosus or rheumatoid arthritis.
The results can show problems with organs like the liver or kidneys, which may occur in systemic autoimmune diseases.
Eye Moisture Evaluation
Eye dryness is a main symptom of Sjögren’s disease. Doctors use the Schirmer tear strip test by placing a strip of paper under the lower eyelid.
The paper measures how much moisture the eyes produce. Eye doctors also use a slit lamp to examine the eye’s surface.
Special dyes like fluorescein make corneal damage more visible. These tests help determine if dryness comes from Sjögren’s or another cause.
Salivary Gland Inspection
Doctors use imaging to check how well the salivary glands work. Sialography uses X-rays and dye to view the ducts and track saliva flow.
Doctors look for blockages or reduced flow, which may signal Sjögren’s disease. Salivary scintigraphy tracks how a radioactive material moves through the glands.
This scan can find problems that other tests might miss. Specialists may also use ultrasound to check for changes in gland structure.
Mouth Gland Tissue Sampling
Doctors sometimes take a tissue sample from the inner lip. They check the sample for clumps of immune cells called lymphocytic infiltration.
The “focus score” from this sample helps confirm the diagnosis, especially if symptoms are mild or unclear. Doctors often use this test along with blood work and imaging to confirm Sjögren’s syndrome.
Treatment
Commonly Used Medicines
Doctors use different medicines to manage symptoms and lower the risk of complications. For dry eyes, prescription eye drops help reduce inflammation.
Eye gels can keep the eyes moist, especially at night. For dry mouth, medicines such as pilocarpine or cevimeline help increase saliva.
Chewing sugar-free gum and sipping water can also bring relief. Antifungal treatments help if mouth dryness leads to yeast infections.
When joint or muscle pain occurs, NSAIDs and other prescription medications can reduce pain and stiffness. Some people may need hydroxychloroquine or immune-suppressing drugs, especially if organs are affected.
Doctors may use stronger medicines like corticosteroids for severe complications such as vasculitis, non-Hodgkin lymphoma, or nerve problems.
Minor Procedures for Dry Eyes
If medicines do not help enough, doctors may suggest a procedure called punctal occlusion. This involves placing small plugs made of collagen or silicone into the tear ducts.
These plugs help keep the eyes moist for longer. This lowers the risk of problems like corneal ulcers and helps with severe dryness.
Some people may also need procedures for issues like reflux or lung infections. It is important to watch for serious problems such as lymphoma if new symptoms appear.
Working with a care team helps manage symptoms and reduce the risk of long-term problems.
Daily Habits and At-Home Care
Caring for the Mouth and Teeth
People with Sjogren’s syndrome often experience dry mouth (xerostomia), which raises the risk of tooth decay and gum disease. Good daily dental care is important.
Brushing and flossing after meals removes bacteria and food that cause cavities. Using fluoride toothpaste and antimicrobial mouthwash offers extra protection.
Saliva helps keep the mouth healthy, but saliva flow is often low. Staying hydrated helps.
Sipping water during the day and chewing sugar-free gum or sucking on citrus-flavored sugar-free candies can boost saliva production. Some people use artificial saliva products, available as sprays or lozenges, to keep their mouths moist longer.
A simple oral health routine may look like this:
| Step | What to Do | When to Do It |
|---|---|---|
| Toothbrushing | Use fluoride toothpaste | After every meal |
| Flossing | Clean between teeth | At least once daily |
| Mouthwash | Use antimicrobial mouthwash | Once per day |
| Dental Check-ups | Visit dentist | At least every 6 months |
Regular dental visits help catch problems early. Topical fluoride treatments from a dental professional give extra protection.
Managing Dryness in Other Areas
People may have dryness in their eyes, skin, nasal passages, and, for some women, vaginal tissues. Artificial tears or eye gels add moisture to dry eyes.
Some people use thicker lubricants at night. Protective glasses outdoors can shield eyes from wind and stop extra evaporation.
Using a humidifier indoors helps keep the air moist. Avoiding fans and air conditioning vents can reduce symptoms.
Drinking water often eases throat dryness. A saline nasal spray keeps the nose moist and may reduce the need to breathe through the mouth.
Skin care should be gentle. Shower or bathe in warm (not hot) water, pat skin dry, and apply moisturizer while skin is damp.
Rubber gloves protect hands during chores. Women with vaginal dryness can use over-the-counter moisturizers or lubricants.
Key tips for managing dryness:
- Use artificial tears for eyes
- Sip water often for the mouth
- Try sugarless gum to boost saliva
- Moisturize skin after washing
- Consider nasal saline
- Use vaginal lubricants if needed
These simple routines help reduce daily discomfort from dryness in Sjogren’s syndrome.
Getting Ready for Your Visit
Steps You Can Take
Before meeting with a healthcare provider, prepare a few details. Making a checklist helps your visit go smoothly.
- Write down your symptoms. Note when they started and any changes.
- Prepare your medical history. List all current and past health problems.
- Family medical background. Share any diseases your relatives have had.
- Medication and supplements. Make a table with all medicines and supplements you take, including doses.
| Medication/Supplement | Dose | Frequency |
|---|---|---|
| Example: Vitamin D | 1000 IU | Daily |
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Questions for the provider. Consider asking:
- What could be causing these symptoms?
- Could something else be the cause?
- What tests will be done?
- What are the treatment options?
- How quickly will treatment work?
- What are possible long-term issues?
- How is care managed with other health conditions?
What the Healthcare Provider May Ask
Be ready for questions from your healthcare provider. These questions help specialists understand your symptoms and health history.
- Do your symptoms get worse during certain times of day or in certain situations?
- Do you have any ongoing conditions such as arthritis or high blood pressure?
- Have you started any new medications recently?
- Does anyone in your family have autoimmune diseases like lupus or rheumatoid arthritis?
Bring this information to your appointment. It helps your provider choose the right tests and treatments.
