Sjögren's Syndrome is an autoimmune disorder caused by chronic inflammation of the body's salivary and tear glands. It manifests with complaints such as dry mouth and dry eyes. Although it is more common in women over 40, it can occur in any age group and significantly affect quality of life.
What is Sjögren's Syndrome?
Sjögren's syndrome is a disease that affects the salivary and tear glands and falls under the category of autoimmune diseases. The syndrome begins with seemingly harmless complaints such as dry eyes and mouth, but it can seriously affect the quality of life. The notable feature of Sjögren's syndrome is its general impact, like other autoimmune diseases that can affect other organs or systems of the body, regardless of which symptoms are prominent.
Since the syndrome is generally not well known, its diagnosis can be delayed, forcing patients to cope with symptoms that decrease their quality of life for a long time.
Types of Sjögren's Syndrome
Sjögren's Syndrome or Sicca Syndrome can occur in two different forms: Primary and Secondary.
Primary Sjögren's Syndrome occurs in individuals without any other health problems. In this case, the body attacks its own tissues, causing inflammation in the salivary and tear glands.
Secondary Sjögren's Syndrome (Sicca Syndrome) can develop in situations accompanied by diseases such as Lupus, Polymyositis, and Rheumatoid Arthritis. The presence of these diseases can lead to the immune system attacking its own tissues, causing symptoms of Sjögren's Syndrome to emerge.
Although it is rare for Sjögren's Syndrome to occur in individuals under 20, it can affect people of all ages and ethnic backgrounds. More than 90% of patients are women. Additionally, if an individual has a family history of Sjögren's Syndrome, they may have an increased risk of acquiring the disease.
Symptoms of Sjögren's Syndrome
Sjögren's Syndrome (Sicca Syndrome) affects each individual differently, and symptoms vary in severity. Common symptoms include:
Dry Mouth
A common symptom of Sjögren's syndrome is dryness in the mouth. Lack of sufficient saliva can lead to dental caries, gum problems, and fungal plaques.
Dry Eyes
Eyes may feel dry and gritty, with burning and redness. Excessive crusting may accumulate during sleep. Eyes can be sensitive to sunlight.
Swelling of Salivary Glands
Our body has three pairs of major salivary glands: under the tongue, in front of the ears, and at the back of the mouth. These glands may sometimes swell and be palpable. The swelling can be similar to that seen in mumps and may become tender, possibly causing fever.
Oral Fungal Infection
Sjögren's syndrome is associated with the presence of a fungus called Candida.
Vaginal Dryness
Sjögren's Syndrome can cause vaginal pain and irritation due to dryness. This condition can be a painful experience for women.
Fatigue
Fatigue is a common symptom, manifesting either as a direct result of the disease or due to the physical and emotional stress of dealing with a chronic illness.
Causes and Risk Factors of Sjögren's Syndrome
Sjögren's syndrome is a complex illness requiring professional medical evaluation. Affecting 1 in 100 people, it can rise to 5% in the geriatric age group of 65 and above. Commonly emerging after the age of 40, it occurs 9-10 times more frequently in women than men.
Symptoms typically begin after the age of 40 and can be mistaken for side effects of medications used for other health problems. This situation becomes more complex with the increased intake of medications for various ailments, from high blood pressure to depression.
Dryness or joint pain occurring in elderly individuals may be interpreted as a natural result of aging, complicating the diagnosis process. All these reasons can delay the accurate diagnosis of the disease.
Impact of Dry Mouth and Dry Eyes on Daily Life
Dry mouth not only causes discomfort but also makes chewing and swallowing difficult, disrupting nutrition. Persistent dry mouth negatively affects dental health, leading to frequent dental cavities.
Dry eyes can cause irritation, redness on the eye surface, and eventually corneal damage. If untreated, permanent deterioration in vision quality may occur.
Methods Used in the Diagnosis of Sjögren's Syndrome
The diagnosis of Sjögren's syndrome begins with listening to the patient's history and conducting a detailed physical examination. Key methods used in diagnosis include:
Patient History
The doctor investigates the origin of the disease by listening to the complaints.
Physical Examination
Changes in your eyes, mouth, or salivary glands, swollen lymph nodes in your neck, tenderness in muscles, and inflammation in joints will be examined.
Chest X-Ray
A chest X-ray is taken to determine if there are any changes in the lungs.
Blood Tests
Special blood tests play an important role in diagnosing Sjögren’s Syndrome. However, not all Sjögren patients may have these symptoms, and not everyone with these symptoms has Sjögren's syndrome.
Schirmer Test
A small piece of filter paper is placed under the lower eyelid to measure tear production.
Slit-Lamp Examination
An effective method to accurately detect dry eyes. During this test, a special drop is applied, and then the eyes are examined with a device called a slit-lamp. The drop is used to identify dry or damaged areas in the eye.
Lip Biopsy
Helps evaluate saliva levels and determine oral moisture.
How is the Treatment of Sjögren's Syndrome Conducted?
Treatment for Sjögren's syndrome requires a long-term plan, and medications like hydroxychloroquine may be used. This medication targets the autoimmune mechanism and tends to damage body cells, often proving beneficial for muscle and joint pains.
To alleviate dry mouth, medications that increase saliva production may be recommended, along with appropriate toothpaste, mouthwash solutions, lozenges, and gums for sensitive teeth.
In case of dry eyes, artificial tear drops or gels may be used, while the doctor may recommend advanced treatments if corneal damage is present.
Managing Sjögren’s Syndrome in Daily Life
As Sjögren’s syndrome is a chronic condition, measures taken in daily life can alleviate dry mouth, dry eyes, and other complaints. Expert support and regular follow-up, along with lifestyle changes, are part of the treatment.
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During winter months, household humidifiers can be used in bedrooms to maintain air humidity, preventing dry eyes and mouth.
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Saltwater sprays can be used to frequently moisturize the nose, facilitating easier breathing.
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Adequate fluid intake throughout the day should be ensured.
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Applying moisturizer after baths against skin dryness can become a habit.
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If there is a complaint of vaginal dryness, support from a gynecologist can be sought.
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If swelling under the jaw or in front of the ear is noticed, a doctor should be consulted.
If medications with hydroxychloroquine are used, high SPF sunscreens can be applied on sunny days. -
Eye exams every six months can help keep dry eyes and eye health in check.
Additional Advice for Dry Eyes:
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With doctor’s approval, artificial tear drops and gel forms can be used regularly to prevent eye dryness.
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Those working in front of screens for long periods can take frequent breaks to rest their eyes.
Frequently Asked Questions
Why does Sjögren's syndrome cause dry mouth?
Sjögren’s syndrome may cause a decrease in saliva production due to the immune system damaging the salivary glands. This can lead to dry mouth, difficulty swallowing, reduced taste sensation, and increased dental cavities.
How is eye dryness treated in Sjögren's syndrome?
Artificial tear drops and moisturizing gels are commonly used treatment methods for dry eyes. Due to insufficient tear quantity, regular use and anti-inflammatory drops under ophthalmologist supervision can be preferred when necessary.
How is Sjögren's syndrome diagnosed?
Diagnosis of Sjögren's syndrome is based on a detailed evaluation of the patient's complaints, tear tests, salivary flow rate measurements, and blood tests showing autoantibodies. A lip salivary gland biopsy may be performed to confirm the diagnosis when necessary.
Can Sjögren's syndrome be completely cured?
Sjögren's syndrome is a chronic condition and full recovery is not possible. However, with regular doctor visits, medication treatments, and lifestyle precautions, symptoms can be significantly controlled and quality of life preserved.