Sjögren’s Syndrome

Sjögren’s syndrome is an autoimmune disease that makes your glands produce less moisture than they should. It causes chronic (long-term) dryness throughout your body, especially in your eyes and mouth.

Sjögren’s syndrome is pronounced “SHOW-gren’s syndrome.” Some healthcare providers call it Sjögren’s disease.

If you have Sjögren’s syndrome, your immune system damages glands in your body that produce and control moisture, including in your:

• Tear system
• Salivary glands
• Nose
• Throat
• Digestive system
• Vagina

Visit a healthcare provider if you’re experiencing new dryness in your eyes, mouth or anywhere else in your body — especially if you’re also experiencing new pain or other symptoms.

Types of Sjögren’s syndrome

Healthcare providers classify Sjögren’s disease into two types:

• Primary Sjögren’s syndrome develops on its own. It isn’t caused by another health condition.
• Secondary Sjögren’s syndrome happens when another condition or issue causes (triggers) Sjögren’s syndrome.

Sjögren’s syndrome symptoms

Unusual dryness is the most common symptom of Sjögren’s syndrome. You might notice:

• Dry eyes or itchy eyes
• Dry mouth, mouth sores or thick spit
• Vaginal dryness
• Dry skin
• Dry nose and frequent nosebleeds
• Dry throat and/or coughing often

In addition to dryness, you might have other symptoms, including:

• Joint pain
• Muscle pain or weakness
• Swollen lymph nodes
• Fatigue
• Trouble swallowing or talking
• Brain fog, trouble thinking or focusing
• Loss of taste
• Cavities or losing teeth
• Skin rashes
• Nerve pain
• Heartburn or other types of indigestion
• Light sensitivity

Sjögren’s disease causes

Sjögren’s syndrome is an autoimmune disease. These happen when your immune system damages your body instead of protecting it. Experts aren’t sure what makes your immune system attack your glands and cause Sjögren’s syndrome.

Primary Sjögren’s syndrome happens with no known trigger or cause.

Other health conditions trigger secondary Sjögren’s syndrome. Autoimmune diseases or viral infections usually cause it.

Any autoimmune disease can lead to secondary Sjögren’s syndrome. Some common triggers include:

• Rheumatoid arthritis
• Psoriatic arthritis
• Lupus

Viral infections that can trigger secondary Sjögren’s syndrome include:

• Hepatitis C
• Cytomegalovirus (CMV)
• Epstein-Barr virus
• Human T-lymphotropic virus 1 (HTLV-1)
• COVID-19

Risk factors

Anyone can develop Sjögren’s syndrome. But you may be more likely to if you:

• Are female: More than 9 in 10 people with Sjögren’s are female.
• Have other autoimmune diseases: Around half of people with Sjögren’s syndrome have at least one other autoimmune condition.
• Are between the ages of 45 and 55: Children, younger adults and adults older than 55 can have Sjögren’s syndrome. But it usually develops in adults in this age range.
• Have a biological family history: You may be more likely to develop Sjögren’s disease if one of your biological parents or siblings has it.

Complications of Sjögren’s syndrome

Sjögren’s syndrome can cause some complications, including:

• An increased risk of mouth and eye infections
• Abnormal liver or kidney function
• Lymphoma
• Lung problems that may be mistaken for pneumonia
• Brain, spine or nerve problems that cause weakness or numbness

Having Sjögren’s might make you more likely to develop other autoimmune conditions. But that doesn’t mean you definitely will.

Most people with Sjögren’s don’t experience severe complications. You may be more likely to if you have secondary Sjögren’s. Ask your healthcare provider what to expect.

How doctors diagnose this disease

A healthcare provider will diagnose Sjögren’s syndrome with a physical exam and some tests. They’ll examine your body and ask about symptoms you’ve experienced. Tell your provider when you first noticed changes in your body. Let them know if certain times of day or activities make the symptoms worse.

Tests that are used

Diagnosing Sjögren’s syndrome is usually part of a differential diagnosis. This means your provider will probably use a few tests to rule out other conditions that cause similar symptoms before diagnosing you with Sjögren’s syndrome. You might need:

• Blood tests
• An eye exam
• A dental checkup
• Urinalysis
• Biopsies
• X-rays

You might need to see a few specialists, including:

• A rheumatologist
• An eye doctor
• A dentist
• An ear, nose and throat doctor

Sjögren’s syndrome treatments

Your healthcare provider will suggest treatments to manage the symptoms you experience. There’s no cure for Sjögren’s syndrome. But your provider will help you find treatments that reduce how often it affects your day-to-day routine.

The treatments you’ll need vary. It depends on where Sjögren’s syndrome affects you.

Some common treatments include:

• Artificial tears: Your eye doctor might suggest over-the-counter (OTC) prescription eye drops.
• Dry eye surgery (punctal plugs): An eye surgeon can surgically close some or all of your tear ducts. This will keep your natural tears in your eyes for longer.
• Saliva producers: Your dentist may suggest over-the-counter supplements or prescription medication to help your body make more saliva. They might suggest you chew gum, sip water throughout the day or suck on ice chips to help moisturize your mouth.
• Special mouthwash or dental care products: Having Sjögren’s disease increases your risk of mouth infections and other dental issues. You may need more frequent cleanings, special fluoride treatments or prescription toothpaste and mouthwash.
• Vaginal moisturizers or lubricants: Your provider will suggest OTC or prescription lubricants to add moisture to your vagina. You may need to use these every day or only before having sex.
• Hormone therapy: Some people need hormone therapy, like supplemental estrogen. This can treat vaginal dryness from a hormonal imbalance.

Treatments for pain and other symptoms can include:

• Over-the-counter pain relievers: NSAIDs and acetaminophen relieve pain and reduce swelling. Don’t take these medications for more than 10 days in a row without talking to your provider.
• Corticosteroids: These are prescription anti-inflammatory medications. Your provider will give you pills or a shot.
• Immunosuppressants: These medications calm your immune system. This may reduce how often you experience symptoms. Your provider might recommend disease-modifying antirheumatic drugs (DMARDs).

When should I see my healthcare provider?

See a healthcare provider if you notice new symptoms. Tell your provider if the symptoms happen more often or are more severe. Monitor the symptoms and keep track of any changes you notice. You might want to keep a symptom journal. This can help you remember everything you experience.

Your provider will tell you how often you’ll need regular follow-up appointments, tests or additional screenings. Sjögren’s disease symptoms can be subtle. You’re the best judge of when something doesn’t feel quite right in your body. Talk to your provider if you think a treatment isn’t working or isn’t as helpful as it used to be.

Go to the emergency room or call 911 (or your local emergency services number) if you feel like you can’t breathe or swallow.

What can I expect if I have Sjögren’s syndrome?

You should expect to manage symptoms for a long time. Maybe for the rest of your life. But the symptoms should get less severe as you find treatments that work for you. You’ll learn how to manage them. Your healthcare provider will help you find new or different treatments as needed. They may be able to suggest new options or adjust your medications if anything changes.