Sjögren’s Disease: Symptoms, Diagnosis and Treatment

What Is Sjögren’s Disease?

Your immune system normally protects you from infections. In an autoimmune disease, the immune system mistakenly attacks healthy tissues.

In Sjögren’s disease, the immune system primarily targets the glands that produce tears and saliva. However, the disease can also affect other organs and tissues throughout the body, including the joints, lungs, kidneys, skin, nerves, and blood vessels.

You may have heard the term Sjögren’s syndrome. Increasingly, experts use the term Sjögren’s disease because it more accurately reflects the systemic nature of the condition.

Sjögren’s may be categorized as:

• Primary Sjögren’s: develops on its own.
• Secondary Sjögren’s: occurs alongside another autoimmune disease, most commonly rheumatoid arthritis, lupus, or systemic sclerosis.

What Causes Sjögren’s Disease?

Researchers do not know exactly what causes Sjögren’s disease. Most experts believe it results from a combination of genetic predisposition and environmental triggers, such as viral infections, which activate an abnormal immune response.

Your risk may be higher if you:

• Are a woman, particularly between ages 45 and 55
• Have another autoimmune disease
• Have a family history of autoimmune conditions

Common Symptoms of Sjögren’s Disease

Dry eyes and dry mouth are the hallmark symptoms of Sjögren’s disease, but many other symptoms can occur.

Dry Eyes

• Burning or stinging
• Itching
• A gritty or sandy sensation
• Sensitivity to light
• Blurred vision

Dry Mouth

• Difficulty swallowing or speaking
• Changes in taste
• Frequent cavities
• Increased dental infections
• Gum disease and tooth loss

Fatigue

Fatigue is often one of the most disabling symptoms of Sjögren’s disease. Many patients describe a profound exhaustion that interferes with work, exercise, and daily activities despite getting adequate sleep.

Joint and Muscle Symptoms

• Joint pain
• Joint stiffness
• Muscle aches

Joint symptoms may occur even in patients who do not have rheumatoid arthritis.

Other Dryness Symptoms

• Dry skin
• Dry nose
• Dry throat
• Vaginal dryness

Other Possible Symptoms

• Swollen salivary glands near the jaw
• Brain fog or difficulty concentrating
• Skin rashes
• Nerve pain or numbness in the hands and feet
• Raynaud phenomenon, in which fingers or toes change color in response to cold temperatures or stress

While dryness symptoms are the most common manifestations, Sjögren’s can occasionally affect organs such as the lungs, kidneys, liver, peripheral nerves, and blood vessels.

Why Sjögren’s Can Be Difficult to Diagnose

Sjögren’s disease is frequently underrecognized because its symptoms overlap with many other conditions.

• Symptoms Overlap with Other Conditions: Dry eyes and dry mouth may be attributed to aging, menopause, medications, allergies, or other medical conditions. Fatigue and joint pain are also common in fibromyalgia, lupus, and rheumatoid arthritis.
• Symptoms Can Seem Unrelated: A patient may discuss dry eyes with an ophthalmologist, cavities with a dentist, and joint pain with a primary care physician without anyone immediately recognizing that the symptoms could be connected.
• No Single Test Confirms the Diagnosis: Doctors use a combination of symptoms, blood tests, eye exams, salivary gland evaluation, and sometimes a tissue biopsy to make the diagnosis.

Tests Used to Diagnose Sjögren’s Disease

A rheumatologist, a physician who specializes in autoimmune and musculoskeletal diseases, usually leads the evaluation.

Testing may include:

Blood Tests

Blood tests may look for:

• Anti-SSA (Ro) antibodies
• Anti-SSB (La) antibodies
• Antinuclear antibodies (ANA)
• Rheumatoid factor
• Markers of inflammation

Some patients with symptoms may need additional testing.

Eye Tests: These tests evaluate tear production and assess for damage caused by dryness on the surface of the eye.

Salivary Gland Testing: Tests may measure how much saliva the glands produce or evaluate gland function.

Lip Biopsy: A small sample of minor salivary glands from the lower lip may be examined under a microscope for characteristic inflammation.

Sjögren’s Treatment and Symptom Relief

Although there is currently no cure for Sjögren’s disease, treatment can relieve symptoms, improve quality of life, and help prevent complications. Your treatment plan depends on which organs and symptoms are involved.

Relief for Dry Eyes

• Artificial tears: Preservative-free drops are often best for frequent use.
• Punctal plugs: Small devices placed in the tear ducts help retain natural tears.
• Prescription medications: Medicated eye drops may reduce inflammation and improve tear production.

Relief for Dry Mouth

• Prescription medications: Certain medications can stimulate saliva production.
• Saliva substitutes: Sprays, gels, and rinses can provide temporary moisture.
• Simple habits: Frequent sips of water, sugar-free gum, and ice chips may help reduce symptoms.

Treating Symptoms Throughout the Body

When Sjögren’s causes joint pain, fatigue, or organ involvement, treatment may include:

• Anti-inflammatory medications for joint and muscle symptoms
• Hydroxychloroquine (Plaquenil) for joint pain, fatigue, and other systemic symptoms in selected patients
• Immunomodulatory medications that help control immune system activity
• More advanced therapies when significant lung, kidney, nerve, or other organ involvement occurs

Protecting Your Long-Term Health

Regular follow-up helps identify complications early and optimize treatment. Because dry mouth can increase the risk of cavities, gum disease, and oral infections, routine dental care is especially important. Regular eye examinations can help prevent complications related to chronic dryness.

People with Sjögren’s disease also have an increased risk of lymphoma compared with the general population, although the overall risk remains low. Notify your physician if you develop persistent salivary gland swelling, enlarged lymph nodes, unexplained weight loss, or other concerning symptoms.

“Sjögren’s is a lifelong condition, but it does not have to define your life. Keeping a symptom journal can help identify patterns, guide treatment decisions, and help patients continue doing the activities they enjoy, “ said Dr. Anand.

Frequently Asked Questions About Sjögren’s Disease

Is Sjögren’s disease serious?

For many people, symptoms remain mild to moderate and can be successfully managed. However, some patients develop disease involving internal organs, which is why ongoing follow-up with a rheumatologist is important.

Can men get Sjögren’s disease?

Yes. Although Sjögren’s is more common in women, men can also develop the disease. Because it is considered less common in men, diagnosis may sometimes be delayed.

Can diet or lifestyle changes help?

Lifestyle changes cannot cure Sjögren’s disease, but they can help reduce symptoms. Consider:

• Using a humidifier at home
• Staying well hydrated
• Limiting alcohol and caffeine if they worsen dryness
• Avoiding tobacco products
• Protecting your eyes from wind, smoke, and dry environments

Learn more about the rheumatology services available at Catholic Health.