Monday, September 5, 2011

Sjogren's Syndrome : Symptoms & Treatment

Sjogren's syndrome is a severe autoimmune disorder in which White blood cells (lymphocytes) attack and destroy the moisture-producing glands like tears and saliva producing glands, so the production of saliva and tears reduces. The name Sjogren's syndrome is given after a Swedish ophthalmologist, Dr.Henrik Sjögren, it was called "keratoconjunctivitis sicca" in the early 1900s. The main symptoms of the disorder include dry eyes and dry mouth (sicca complex) along with a range of other symptoms like fatigue and joint pain. In few cases, lymphocytes also affect internal organs such as the nervous system, the kidneys, the intestines, the lungs and the liver.
Sjogren's Syndrome : Symptoms & Treatment
Sjogren's syndrome is classified in 2 types: primary or secondary. Primary Sjogren's syndrome occurs on its own alone; secondary Sjogren's syndrome is seen in association with another disease, such as systemic lupus erythematosis (SLE) and rheumatoid arthritis. Rheumatic diseases are conditions affecting bones, skin, joints and muscles. It is most often observed in elderly and middle-aged women, especially in white women. 0.1%-3% population of the United States and 3-4% of adults in the UK are affected by Sjögren's syndrome. It is the 2nd most common autoimmune disease after rheumatoid arthritis. It often occurs in people having other rheumatic disorders such as systemic lupus erythematosis, scleroderma and rheumatoid arthritis.

Symptoms of Sjogren's Syndrome

The Symptoms are varying from person to person. Symptoms of this syndrome are the result of smashed exocrine glands and can affect the mouth, eyes, nose, throat, digestive system, airways, skin and vagina. The two main symptoms are:
  • Extremely dry eyes (xerophthalmia) which cause a blurry vision with a gritty, dry, itchy or burning sensation in the eyes.
  • Extremely dry mouth (xerostomia) causing difficulty in chewing, talking and swallowing. It may decrease sense of taste and increase dental cavities. Sometimes redness and cracks in the corners of the mouth.
The other symptoms are common and can be caused by other medical disorders, anxiety and by some medications.
  • Dry or blazing throat which leads continual dry cough
  • Recurrent bronchitis and pneumonia
  • Inflammation of the salivary glands on both side of your face
  • Increased thirst
  • A sore or cracked tongue
  • A change in smell or taste
  • Dry or flaking lips
  • Dryness of skin with rashes
  • Dryness of nose
  • Fatigue
  • Dryness of vagina and Painful sexual intercourse
  • Heartburn and Acid reflux
  • Morning stiffness
  • Joint pain
  • Augmented dental decay
  • Digestive problems
  • Abnormalities of thyroid gland
  • Swelling of the liver, kidneys, lungs, or pancreas
  • Joint pain, inflexibility and inflammation
  • Irritable bowel syndrome (IBS), which may comprise tummy (lower abdominal) pain
  • Sometimes red-purple skin lesions occur on the legs because of inflammation of blood vessels in the skin
  • Irritation of the nerves in the hands, arms, feet or legs (neuropathy)

Treatment of Sjogren's Syndrome

Sjogren’s syndrome can not to be cured totally but with early detection and treatment, you can minimize the symptoms and risk of complications.

Number of treatments are available that can relieve the symptoms.

Self-assist
You can do many things by yourself to control your symptoms.
  • Avoid too much sweet foods or alcohol to reduce the dryness of mouth. If you have habit of smoking, try to stop it because it worsens symptoms. Suck ice cubes or take small sips of water throughout the day to maintain your mouth moist.
  • If your eyes become dry, irritable or sore, then stay away from smoky, dusty and air-conditioned environments. Use contact lenses or specialist spectacles to reduce dryness.
  • If your skin becomes dry, then take shower besides bath and moisturize it regularly.
  • Chew sugarless pastilles or chewing gum to increase production of saliva.
  • Regular clean your teeth and use dental floss to avoid symptoms of tooth decay.
  • Use of humidifier in your sitting room/bedroom is also helpful.
  • To avoid vaginal dryness use lubricants, such as oestrogen creams and KY jelly.
  • Balance exercise and rest. Balanced exercise programs may help patients to overcome joint and muscle pain, maintain flexibility and overcome fatigue.
Medicines
It is a chronic disease which has no cure; but, by using moisture replacement therapies you can relieve dryness. These include preservative-free artificial saliva's, artificial tears, vaginal lubricants, saline nasal sprays and unscented skin lotions. Try different options until you get the best suitable option for you. Consult specialists such as Ophthalmologist, Otolaryngologist, Dentists for specific complications of Sjögren's syndrome.

By use of mouth lubricants, saliva substitutes and artificial teardrops, you can moist your mouth, throat and eyes.
  • Artificial saliva may be recommended by your specialist, if you have a complaint of dry mouth. Artificial saliva is available in the form of a gels, mouth spray or lozenges. Some of them also contain fluoride.
  • Artificial tears are useful but frequently they do not last long enough. So use of thicker preparations which lasts longer is recommended. Eye drops or ointments are useful to control the dryness of eyes. Use them several times a day. Many different types of ointments and eye drops are available. Your pharmacist or specialist can advise you which one is most suitable for you. Eye drops which contain cyclosporine may increase tear production and treat swelling in the glands around the eyes. Antibiotics are also available to treat eye redness, pain and swelling.
  • For a fungal infection in mouth, your specialist may recommend an antifungal medication such as miconazole oral gel. If you have a complaint of ulcers in your mouth, your specialist may recommend an ointment to apply on the ulcers.
  • Pilocarpine may be prescribed by your specialist to stimulate saliva and tear production. But this medicine has several side-effects and may not work for all people having Sjögren’s syndrome.
  • For vaginal dryness, use of Estrogen creams may be recommended by your specialist.
  • To relieve joint and muscle pain, steroid medicines may be prescribed. Sometimes, DMARDs (Disease-modifying antirheumatic drugs) such as methotrexate are prescribed to relieve dry skin and joint pain and also prescribed when the internal organs are affected by disease.
  • Painkillers such as paracetamol and ibuprofen may help to relieve painful joints associated with syndrome. Mild pain-relieving medications such as acetaminophen or Motrin or Aleve may help to reduce joint or muscle pain.
Hospital treatment
  • When artificial tears are not sufficient, surgery which slows the disappearance of tears by sealing or blocking the tear ducts is another treatment option. Punctal occlusion may be suggested by an ophthalmologist to prevent the tear ducts that drain tears from eyes.

1 comments:

This was very informative. I'm waiting for diagnosis. Short of a miracle, I probably have this disease.

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