Sjogren’s syndrome

Sjogren's syndrome guidebook

sjogren’s syndrome is an autoimmune disease that primarily affects the salivary and lacrimal glands. It belongs to the group of collagenoses, which are autoimmune diseases that affect the entire body. After rheumatoid arthritis, it is the second most common inflammatory rheumatic disease. Four out of every 1000 people suffer from sjogren’s syndrome.

In sjogren’s syndrome, the lacrimal and salivary glands are usually inflamed first. As a result, the glands produce less fluid. This leads to dry eyes with conjunctivitis and a dry mouth. As it progresses, other mucous membranes also dry out (respiratory tract, vagina). This dryness symptom is also called sicca syndrome (siccus: dry) by doctors. The disease often affects not only the glands, but the entire organism.

Sjogren’s syndrome can occur as a disease in its own right (primary sjogren’s syndrome) or as a consequence of another disease (secondary sjogren’s syndrome), such as rheumatoid arthritis or systemic lupus erythematosus. Women are ten times more likely than men to suffer from this form of rheumatism.

The causes – how does sjogren’s syndrome develop??

The causes of sjogren’s syndrome are not known. It can be that infections play a role, stress or changes in the hormone balance.

Doctors, on the other hand, can explain how the inflammation develops. sjogren’s syndrome is an autoimmune disease. This means that cells of the immune system, which is supposed to fight off illnesses, attack the patient’s own body. Why this happens, doctors do not know.

Inflammatory rheumatic disease is a risk factor. Many patients with rheumatoid arthritis, systemic lupus erythematosus or other collagenosis also develop secondary sjogren’s syndrome.

The symptoms

Most of the affected people are mainly burdened by the following symptoms:

  • Dry mouth, dry eyes, in women dry vaginal mucosa (sicca syndrome)
  • Strong exhaustion (fatigue)
  • Joint and muscle complaints
  • Temporarily swollen salivary glands and cervical lymph nodes
  • Dry and itchy skin
  • Circulatory disorders in the fingers (raynaud’s syndrome)
  • Sleep disturbance

in rare cases, sjogren’s syndrome also affects the lungs, kidneys, gastrointestinal tract or nerves. The blood vessels can also become inflamed (vasculitis).

Rarely, a lymph gland tumor (lymphoma) develops during the course of the disease. However, if detected in time, it is completely curable. Regular check-ups are therefore important.

The diagnosis

The first symptoms of sjogren’s syndrome (dry eyes and a dry mouth) can have many other causes, such as

  • Taking diuretics (diuretic drugs)
  • Taking certain medications for depression
  • After irradiation of the head
  • With chronic stress

Therefore, in many cases, doctors do not recognize sjogren’s syndrome, and it can take years before a diagnosis is made.

In order to track down the disease, the doctor can first check whether there is too little salivary or lacrimal fluid by means of functional tests. For this purpose, he checks with a strip of litmus paper in the conjunctival sac of the eye, whether the paper stains, only then tear fluid is present (schirmer-test). Using a gauze compress that the patient chews on for two minutes and which is weighed beforehand and afterwards, when it is soaked with saliva, he determines whether the mouth is unusually dry (saxon test).

The doctor can also examine the salivary glands using imaging techniques (ultrasound, scintigraphy, sialography, magnetic resonance imaging). If a suspicion arises, the otolaryngologist, after a local anesthetic, takes a lip biopsy from small salivary glands, which are analyzed under the microscope. This is how sjogren’s syndrome can be proven or ruled out.

Blood tests: as with most collagenoses, antibodies against cell nuclei, anti-nuclear antibodies (ANA), are also detectable in sjogren’s syndrome. A subgroup, the anti-ro and anti-la antibodies, are characteristic of sjogren’s syndrome, but can occasionally also be detectable in systemic lupus erythematosus.

The therapy – what are the possibilities?

sjogren’s syndrome is not curable. But there are various ways to alleviate the symptoms of those affected.

1. Drug therapy

There are currently no effective medications for sjogren’s syndrome. But various remedies can effectively mitigate or suppress individual symptoms. Each patient must find out for themselves which medicines work best.

Artificial tears or saliva can help with dryness symptoms. The drug pilocarpine stimulates fluid production by the glands. For complaints that affect the entire organism, there are various medications to choose from. You can find an overview in our leaflet.

2. Non-drug therapy

Certain behaviors can help you live better with the disease. Here are some tips:

  • Brush your teeth regularly. Use fluoride toothpaste.
  • Go to the dentist regularly. Have your teeth professionally cleaned regularly.
  • Drink regularly to keep the oral mucosa moist. Avoid drinks containing sugar.
  • Chew sugarless chewing gum. This stimulates saliva production.
  • Make sure the air is well humidified. Avoid air conditioners.
  • Avoid rooms where people smoke and do not smoke yourself.
  • Stay out in the fresh air a lot.
  • Protect your eyes. Wear glasses especially in drafts or sunshine.
  • If you have dry skin, do not use foam baths, but instead use moisturizing washing lotions.
  • Allow yourself rest breaks. Take a midday nap.

Another important piece of advice for all chronically ill people is to find people with whom they can talk about their illness and their experiences. This can help you cope with the psychological stresses that come with any chronic illness. It is therefore always advisable to seek psychological advice in addition to medical advice.

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