How is Sjögren's syndrome treated?

There is no cure for Sjögren's syndrome, but it can be treated and managed. The goals of treatment are to decrease discomfort and reduce the harmful effects of dryness. Generally, physicians use medications to control symptoms (symptomatic treatment). The type of treatment will be tailored to each patient's symptoms and needs.

Good oral hygiene

Good mouth/dental care may prevent or reduce dental decays, infections, or tooth loss:

  • Toothpastes (biotene type) and oral gels are available for people with dry mouth symptoms. These products may also have antibacterial action to reduce the severity of dental cavities over a long period of time.
  • Chewing sugar-free gums can be helpful.
  • Taking frequent sips of water without swallowing (spitting it out) may improve dry mouth.
  • Fluoride treatment provided by dentists may be of benefit.

Increasing eye moisture

Dry eyes are mainly treated with the use of artificial tears. A wide variety of over-the-counter products is available. Artificial tears can be used regularly and more often in dry environmental conditions such as on airplanes, in air-conditioned buildings, and on windy days.

While artificial tears are helpful, they often do not last long enough. Thicker preparations (gel form) that last longer are available. These are often used at bedtime because they can sometimes cause blurry vision. Eye doctors can prescribe an eye drop called Restasis to treat more severe form of dry eyes.

A small procedure called punctal plugs, to slow the disappearance of tears, is another treatment option when artificial tears are not sufficient.

Medications

Medications that tend to reduce body fluids should be avoided.

Mild pain-relieving medications (analgesics), including acetaminophen (such as Tylenol®) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin®) and naproxen (Aleve®), may reduce muscle or joint pain.

The anti-rheumatic drug hydroxychloroquine has been beneficial in some patients for decreasing pain and salivary gland swelling. This drug generally does not help with dry symptoms or fatigue, however.

For the rare patient with internal organ involvement, steroids and immunosuppressive medications may be used. These include medicines such as prednisone (a steroid) and, rarely, chemotherapy-type medications.

Balance of rest and exercise

Guided exercise programs can help patients overcome fatigue, maintain flexibility, and overcome joint and muscle pain. Good sleep hygiene is helpful for improving fatigue and body pain.

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