Sjogren’s syndrome can lead to complications due to a decrease in tears and saliva. Singapore General Hospital (SGH) Department of Rheumatology and Immunology shares the treatment options and care tips.
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Sjogren's syndrome is a chronic disorder of the immune system which destroys glands producing saliva and tears. The condition is more common in women than men in their 40s but Sjogren's syndrome can develop at any age.
Sjogren’s syndrome diagnosis and treatment
Sjogren’s syndrome is often diagnosed with the help of blood tests, a salivary flow rate test, eye exam (e.g. Schirmer’s test), and imaging tests. A salivary gland biopsy may also be carried out to aid in the diagnosis. Sjogren’s syndrome treatment varies depending on the severity of the patient’s condition and which part of the body it affects.
“Since Sjogren’s syndrome affects each patient differently, a personalised plan is developed for each individual,” says Dr Chew.
In mild cases, patients may apply daily eye drops to relieve their dry eyes, and drink regular sips of water to relieve their dry mouth. Over-the-counter moisturizing creams, lubricants and painkillers may be used to treat other symptoms such as dry skin, vaginal dryness and joint pain, respectively.
“Patients with mild symptoms may use several approaches to conserve tears, including increasing ambient humidity indoors and using physical barriers such as wrap-around sunglasses to avoid drying or irritation of the eyes; and chewing sugarless gum to boost saliva production,” says Dr Chew.
In moderate to severe cases, a doctor may prescribe artificial saliva products or medication (e.g. pilocarpine), to increase production of saliva, and topical cyclosporine for dry eyes.
Systemic anti-inflammatory or immunosuppressive medications, such as steroids or hydroxychloroquine, may be beneficial in certain patients with joint pains and other extraglandular disease, although they are generally not used for the treatment of dry eyes or mouth alone.
For severe dry eyes, a minor surgical procedure, called punctal occlusion, may be recommended to temporarily seal the tear ducts and slow down the rate of tear drainage. A laser can also be used to permanently seal the tear ducts. The goal is to have the natural tears stay longer on the eyes, instead of being quickly drained out.