Sjögren’s Syndrome - Know It All!

Editorial

All you need to know about Sjögren’s Syndrome.

Know your ailment well, so you can manage it better!!

Here we come with Sjögren’s Syndrome today!

Overview:

Sjögren’s Syndrome is also known as “Sicca Syndrome”.

Sjögren ‘s syndrome is an inflammatory disorder which may affect many parts of the body but mainly affects the tear and saliva glands. Patients with this condition can experience discomfort, discomfort or painful eye burning. Dry mouth and swelling of the glands around the face and neck (or difficulty in consuming dry foods) are also usual. Some patients experience nasal dryness, throat, vagina and skin. Swallowing problems and acid reflux symptoms are also common.

Sjögren’s “primary” syndrome exists in individuals with no other rheumatic disorder. Sjögren’s “secondary” occurs in individuals with another rheumatological disorder, systemic erythematosus and rheumatoid arthritis most commonly. Often it may be mistaken for a newly identified condition called IGG4.

Most Sjögren syndrome complications arise due to reduced tears and saliva. Patients with dry eyes have an increased risk of eye infections and corneal injury. Dry mouth can lead to an increase in dental decay, gingivitis, and oral yeast (thrush), which may lead to pain and burn. There are episodes of painful swelling in the saliva around the face of some patients.

Complications can occur in other parts of the body. In certain patients, even without rheumatoid arthritis or lupus, pain and rigidity in the joints with mild swelling may occur. Brace and leg rashes in small vascular blood (vasculitis) and lung, liver, and kidney inflammation are uncommon and difficult to diagnose. In some patients too, stupidity, tingling, and weakness were identified. The parotid gland is on the outside of the jaw and some people with Sjögren ‘s syndrome may become swollen and inflamed.

Types:

Sjögren ‘s syndrome is categorised as primary or secondary. You have Sjögren ‘s primary syndrome if you have no other rheumatic disorders. If you have another rheumatic condition, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, or polymyositis, you have secondary sjögren ‘s syndrome.

What Happens in the disease:

It is not clear what causes scleroderma. Researchers nevertheless assume that the immune system overreacts and destroys the cells that line blood vessels. This leads to the formation of too many collagen and other proteins by connective tissue cells, especially cell types called fibroblasts. The fibroblasts live longer than average, causing a collagen build-up in the skin and other bodies, which contributes to sclerodermic signs and symptoms.

Who Gets The disease:

Sjögren’s disease can affect individuals of both sexes and all ages, but the majority of cases occur in women. The average onset age is late in the forties, but Sjögren syndrome in children is rarely diagnosed.

Causes and Risk Factors:

Sjogren‘s syndrome is a disease of the autoimmune system. Your immune system destroys your own cells and tissues incorrectly.

Scientists don’t know why certain people are developing Sjogren‘s syndrome. Some genes put people more at risk for the disorder, but a triggering mechanism, like virus infections or bacterial strain, also appears to be necessary.

Your immune system in Sjogren‘s syndrome targets the glands that produce tears and saliva. But other parts of the body may also suffer, such as:

  • Joints
  • Thyroid
  • Kidneys
  • Liver
  • Lungs
  • Skin
  • Nerves

Sjogren’s syndrome typically occurs in people with one or more known risk factors, including:

  • Age. Sjogren’s syndrome is usually diagnosed in people older than 40.
  • Sex. Women are much more likely to have Sjogren’s syndrome.
  • Rheumatic disease. It’s common for people who have Sjogren’s syndrome to also have a rheumatic disease — such as rheumatoid arthritis or lupus.

Symptoms:

Sjögren ‘s syndrome can cause a variety of symptoms, the most common are:

  • Dry eyes. Your eyes can burn or itch if you have Sjögren ‘s syndrome. Some people complain it feels like sand is in their eyes. You can have trouble with blurred vision or lighting, especially fluorescent lighting.
  • Dry mouth. Your mouth can feel calcareous or your mouth is full of cotton if you experience Sjögren ‘s syndrome. It can be hard to chew, speak, or taste. Since saliva is not safe, you can develop additional tooth decay (cavities) and mouth infections.

Other body parts can also be affected by Sjögren syndrome, causing symptoms such as:

  • Multiple joint and muscle pain sources.
  • Extensive dry skin.
  • Skin rashes on the limbs.
  • Chronic dry cough. Chronic dry.
  • Dryness of the vagina.
  • Sleepiness or tingling in the muscles.
  • Long exhaustion that interferes with everyday life.

Lymphoma can develop in a small number of people with Sjögren ‘s syndrome. Its a type of cancer of the salivary glands, lymph nodes, gastrointestinal tract or lung may be affected by lymphoma. If you have salivary gland enlargement, please contact your doctor.

Additional signs can include:

  • Fever whose cause is unexplained.
  • Sweats at night.
  • Constant tiredness.
  • Weight loss unexplained.
  • Itchy eyes. Itchy eyes.
  • Reddened skin spots.

Many of these may be signs of other disorders, like the syndrome of Sjögren. However, if you have any of these symptoms, it is best to see your doctor.

Diagnosis:

Sjogren syndrome can be difficult to diagnose as the symptoms and signs differ from person to person and maybe identical to those due to other conditions. The side effects of a number of medicines also evoke certain Sjogren syndrome signs and symptoms.

Tests can help to rule out other conditions and to detect Sjogren‘s syndrome diagnosis.

Blood tests:

Your doctor might order blood tests to check for:

  • Levels of different types of blood cells
  • Presence of antibodies common in Sjogren’s syndrome
  • Evidence of inflammatory conditions
  • Indications of problems with your liver and kidneys

Eye tests:

Your doctor may use a test called a Schirmer Tear Test to measure the dryness of your eyes. Under your lower eyelid is a small piece of filter paper to calculate your output.

A physician who specialises in the treatment of eye disorders (ophthalmologist) may also examine your eye surface with a lengthening device called a slit lamp. He or she can put drops in your eye to make it easier to see corneal damage.

Imaging:

Certain imaging tests can check the function of your salivary glands.

  • Sialogram. This unique X-ray will detect a colouring injecting in front of your ear in the salivary glands. This technique illustrates how much saliva flows through the mouth.
  • Salivary scintigraphy. This particular X-ray will detect a colouring injection in the salivary glands in front of your ear. This technique shows the amount of saliva in the mouth.

Biopsy:

Your physician may also perform lip biopsy to detect inflammatory cell clusters that may indicate Sjogren‘s syndrome. For this procedure, a sliver of tissue is removed and examined under a microscope from the salivary glands in your lip.

Treatment Options:

Depending on which part of the body is affected, care may vary from person to person.

Treatment for Dry Eyes:

Many remedies can be tried or the doctor can prescribe dry eyes. Here are others who may help:

  • Eye drops retain your eyes moist until natural tears are replaced. These drugs can be purchased by prescription or over the counter under several labels. Eye drops come in different thicknesses so you can need to try to find the correct thickness. Some drops contain preservatives that can make the eyes irritable. Drops without preservatives don’t normally bother your eyes.
  • The salts are deeper than the drops of the eye. They are the most effective during the sleep because they moisturise and protect the eye for many hours and can blur the eyesight.
  • More extreme cases can require additional therapies such as plugging or blocking of tear ducts, anti-inflammatory drugs or surgery.

Treatment for Dry Mouth:

  • There are also dry mouth remedies. Some of them can be tried by yourself. Others may be recommended by your doctor. Many people here find it useful:
  • Chewing gum and sweetheart. If your salivary glands are still producing saliva, you can stimulate them by chewing gum or sucking hard sweets. Gum and sweets, however, must be free from sugar, because dry mouth makes you highly susceptible to progressive dental decay.
  • Take water or other non-carbonized drink all day, particularly when you eat or talk, to wet your mouth. Remember that drinking huge quantities of liquid all day long doesn’t make your mouth less dry and urinates more frequently. Just small sips of liquid should be taken, but not too much. If you drink fluids every few minutes, the mucus covering in your mouth can be decreased or replaced and your feeling of dryness increases.
  • Using a lip balm or lipstick based on oil or petroleum will soothe rough, cracked lips. If your mouth is hurt, your doctor can give you mouth rinse, ointment or gel to manage pain and inflammation in the sore areas.
  • It is also suggested that other treatments, including saliva substitutes or drugs that activate salivary gland to produce saliva, are used.

Treatment for Symptoms in Other Parts of the Body:

If you have an extra glandular involvement, which means that your eyes and mouth are not moisturised, your doctor can treat these problems by using nonsteroidal inflammatory medicines (NSAIDs) or immune-modifying medications.

How to cope up:

General tips for eye care:

  • Don’t use eye drops that make your eyes irritable. If you’re offended by a brand or medication, try another. Eye drops without preservatives are typically necessary for long term usage.
  • Blinking practise. Blinking practise. When you read or use the screen, you appear to blink less. Mind 5 to 6 times a minute to blink.
  • Cover your eyes from draughts, wind and breeze.
  • Put moisturisers in the rooms, including your bedroom, where you spend the most time or instal a humidifier in your heating/air conditioning unit.
  • Smoke not and keep out of smoky spaces. Don’t smoke.
  • Apply mascara just to your tips, so your eyes don’t get it. If you are using eyeliner or eyeshadow, place it just over the skin, not under the sensitive skin, close to your eyes. Stop facial creams on the lower skin at bedtime when you wake up with discomfort in your eyes.
  • Ask your doctor if any drugs you take lead to dryness. Ask how dryness can be minimised if you do.

Significance of oral hygiene:

  • Natural saliva contains substances that expel bacteria from the mouth causing caries and mouth infections, so good oral hygiene is highly necessary when your mouth is dry. What would you do to avoid cavities and infections?
  • Visit a dentist regularly for inspection and cleaning of the teeth at least twice a year.
  • Rinse your teeth many times a day with water. Do not use alcohol-containing mouthwash because alcohol is drying.
  • Using toothpaste that contains fluoride to gently clean after and before bedtime, your teeth, your gums and your tongue. Non-smoking toothpaste less desiccates.
  • Your teeth flow every day.
  • Avoid sugar amongst food. That means that gum, candy and soda are sugar-free. When you eat or drink sugar, brush your teeth straight away.
  • If you find something odd or have persistent burning or other oral signs, see the dentist immediately.
  • Ask your dentist about taking fluoride supplements, using the fluoride gel during the night, or using a varnish to protect the enamel on your teeth.

Protect your Voice:

You can develop hoarseness if their vocal cords become inflamed or become irritated from throat dryness or coughing. To prevent further strain on your vocal cords, try not to clear your throat before speaking. Clearing your throat is hard on the vocal cords. To avoid irritating your vocal cords:

  • Sip water.
  • Chew sugar-free gum.
  • Suck on sugar-free candy.
  • Make an “h” sound, hum, or laugh to gently bring the vocal cords together.

Medicines and Dryness:

Certain drugs can contribute to eye and mouth dryness. If you take any of the drugs listed below, ask your doctor whether they could be causing symptoms. Don’t stop taking any medicine without asking your doctor. Sometimes your doctor can make adjustments to the dose to help protect you against drying side effects or chose a drug that’s least likely to cause dryness. Drugs that can cause dryness include:

  • Antihistamines.
  • Decongestants.
  • Diuretics.
  • Some antidiarrheal drugs.
  • Some antipsychotic drugs.
  • Tranquillizers.
  • Some blood pressure medicines.
  • Antidepressants.

References:

https://medlineplus.gov/sjogrenssyndrome.html

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome

https://www.niams.nih.gov/health-topics/sjogrens-syndrome/advanced#tab-living-with

https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221

By,

Gopala Krishna Varshith,

Content Developer & Editor,

Clipo.

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