What is it about ?
Sjögren’s syndrome is an autoimmune disease, i.e. that the body produces antibodies directed against its own organs and / or tissues. In the case of Sjögren’s syndrome, antibodies are produced against the glands in the mucous membranes. Usually, the syndrome affects the glands that produce saliva (salivary glands) and the glands that produce tears (tear glands), but the nose, vagina, airways and intestines can also be affected. This syndrome is manifested by chronic inflammation of the glands causing them to work less well and produce less fluid.
The syndrome can be primary or secondary.
- In primary Sjögren syndrome, the disease exists ‘on its own’
- In secondary Sjögren syndrome, the disease is the consequence of another autoimmune disease, for example, rheumatic disease.
In whom and how often does it occur?
The disease affects approximately 1 in 1000 people. It affects up to 10 times more women than men, usually between the ages of 40 and 50, but the disease can occur at any age. About 10 to 15% of the population with rheumatoid arthritis also have symptoms of Sjögren syndrome.
How to recognize it?
The most common symptoms are dry mouth and dry eyes. When you have dry eyes, you feel like you have sand in your eyes, they are red, tired and sensitive to light. A dry mouth causes difficulty in swallowing, dental caries or even cracks in the tongue and chapped lips.
Other possible symptoms are:
- repeated swelling of the salivary glands under the tongue, under the mouth or in front of the ear;
- decreased taste and smell;
- dry skin, scabs in the nose, dry throat, dry cough, chronic respiratory tract infection;
- dryness of the vagina, pain during intercourse;
- general symptoms: fatigue, joint pain, ‘white’ fingers and toes (Raynaud’s phenomenon);
- rarely: an increase in the size of the liver or inflammation of the pancreas (acute pancreatitis) with severe stomach pain;
- other autoimmune diseases such as inflammation of the thyroid.
Usually the disease is not serious, but the symptoms can be very bothersome. People with Sjögren syndrome have a higher risk of developing cancer of the lymph nodes (lymphoma), but this is exceptional.
How is the diagnosis made?
If you have dry eyes or have suffered from a dry mouth for more than 3 months, your doctor will need to examine you:
- blood test with measurement of specific antibodies. If these antibodies are not found in your blood, it is unlikely that you will have Sjögren syndrome.
- eye examination with the Shirmer test. A small strip of paper is used to assess the amount of tears in the eye.
- an ultrasound of the salivary gland is used to see changes in structure and function.
- salivary gland biopsy: a small piece of tissue is removed from the lower lip for examination under a microscope.
If you have characteristic symptoms and the tests are positive, you probably have Sjögren’s syndrome.
What can you do ?
It is not possible to cure this condition. However, we can try to relieve the symptoms:
- through good oral hygiene and regular visits to the dentist;
- quitting smoking and drinking less alcohol;
- using a humidifier in the home and at work;
- using a lubricant during sex;
- by drinking small gulps of water in case of dry mouth. It is sometimes said that sucking on sour candy promotes the production of saliva. But beware, because they are bad for the teeth.
What can your doctor do?
Treatment can be topical to reduce local symptoms, or general to curb the disease.
Local treatment
Artificial tears to keep the eyes moist: they exist in the form of drops (eye drops), gel or ointment, to be applied several times a day. Most of these products contain preservatives. They can cause an allergic reaction and make eye symptoms worse. So choose products without preservatives in case of prolonged use.
Artificial saliva to hydrate the mouth.
General treatment
Hydroxychloroquine is used in the treatment of rheumatic conditions. The doctor may prescribe it for you if you have joint pain and if the result of the blood test is abnormal.
Immunosuppressive drugs and cortisone may be indicated in people who, in addition to mucosal problems, also have other abnormalities.
Want to know more?
- Stop smoking. It’s possible – Tabacstop
- Hydroxychloroquine – CBIP – Belgian Center for Pharmacotherapeutic Information
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
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