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Brief about Sjögren's syndrome
Sjögren's syndrome is a chronic autoimmune disease in which the immune system attacks glands that produce tears and saliva. The most common symptoms are long-term dry eyes and dry mouth, but the disease can also cause fatigue, joint pain and affect other organs.
Common symptoms are dry eyes, dry mouth, severe fatigue and joint pain.
Dry mouth increases the risk of tooth decay, gum disease and fungal infection in the mouth.
The disease is most common in women and often develops slowly over several years.
The diagnosis is based on a combination of symptoms, eye and saliva tests and blood tests for autoantibodies, sometimes supplemented with a labial salivary gland biopsy.
Sjögren's syndrome cannot be cured, but eye drops, saliva replacement and other treatments can relieve symptoms and reduce the risk of complications.
Long-term problems with dry eyes and dry mouth should be investigated, especially if they are combined with fatigue, joint pain or recurrent cavities. teeth.
Dry eyes that sting in front of the screen. A mouth that feels sticky when you're about to speak at a meeting or swallow a sandwich. Many people first think of stress, age, medication or that it's due to dry indoor air. But when Sjögren's syndrome is behind it, the problems are often more long-lasting, and they can affect both everyday life, dental health and general energy.
What does Sjögren's syndrome mean?
Sjögrens syndrome is a chronic autoimmune disease. This means that the immune system mistakenly attacks the body's own tissues, especially the glands that produce tears and saliva. The result is often dry eyes and a dry mouth, but the disease can also cause fatigue, joint pain and affect other organs.
The disease can occur alone, so-called primary Sjögren's disease, or together with other rheumatic diseases such as rheumatoid arthritis, SLE or systemic sclerosis. It is most common in women and often debuts in middle age, but can occur at other ages and in men.
What makes Sjögren's syndrome particularly easy to miss is that the symptoms often develop gradually. Many people get used to always having a water bottle close at hand, using eye drops frequently or waking up at night with a dry throat without thinking that the symptoms may have a common medical explanation.
When dry eyes and dry mouth are more than just common dryness complaints
Dry eyes in Sjögren's syndrome are often described as burning, a gritty feeling, sensitivity to light or periods of blurred vision. Some also experience irritated eyelids or difficulty wearing contact lenses. The fact that the eyes can run at the same time sounds contradictory, but is common when the surface of the eye is irritated.
Dry mouth is not just about thirst. Saliva is needed to protect mucous membranes, help with speech and swallowing and reduce the risk of caries and fungal infections in the mouth. When saliva production decreases, you may need to drink with every bite, have a hoarse voice or experience food getting stuck.
Common signs that should raise suspicion are:
dry eyes daily for months
dry mouth that makes it difficult to eat dry food
recurrent cavities in the teeth despite good oral hygiene
swelling of the salivary glands, often in front of the ears
pronounced fatigue, joint or muscle pain at the same time as dryness symptoms
Not everyone with dry eyes or dry mouth has Sjögren's syndrome. The problems can also be due to medications, diabetes, old age, screen habits, eyelid inflammation, radiation therapy or other diseases. This is precisely why a comprehensive assessment is important.
What other symptoms can Sjögren's syndrome cause?
For many, the disease does not stop at the eyes and mouth. Fatigue is one of the most common symptoms and can be disproportionately large compared to how active you appear to be. Joint pain, muscle pain and morning stiffness are also common, even without clearly swollen joints.
Some also experience dryness in the nose, throat, skin or genitals. This can cause nosebleeds, a persistent cough, hoarseness, dry skin or pain during intercourse. Others notice recurring inflammation in the eyes or oral mucosa, or become unusually sensitive to bright light and drafts.
In a smaller group, other organs are also involved, such as the lungs, kidneys or nervous system. This is rarer, but medically important because such effects may require specialist treatment. People with Sjögren's disease also have an increased risk of lymphoma, although the overall risk is still low for the individual person.
How Sjögren's syndrome is diagnosed
There is no single blood test that alone confirms Sjögren's syndrome. The diagnosis is instead based on a combined assessment of symptoms, examination findings and laboratory tests. Often a rheumatologist coordinates the investigation, but ophthalmologists, dentists and primary care also play important roles.
Swedish healthcare practice and international criteria include tests of tear production and salivary function, blood tests for autoantibodies and sometimes salivary gland biopsy. Schirmer's test measures how much tears the eye produces. Saliva measurement shows whether saliva flow is abnormally low, and blood tests can detect antibodies such as anti-SSA/Ro. Read more about the S-ANA blood test, which is used to detect autoantibodies and can provide important information when Sjögren's syndrome and other autoimmune diseases are suspected.
A salivary gland biopsy may be indicated if the symptoms suggest the disease but the antibodies are not clearly positive. Then, small salivary glands in the lower lip are examined under a microscope to see if there is the type of inflammation seen in Sjögren's disease.
The investigation also needs to distinguish Sjögren's syndrome from other causes of dryness. Examples include antihistamines, certain antidepressants, blood pressure medications, diabetes, thyroid disease and other autoimmune conditions. Therefore, the assessment is often supplemented with general tests such as blood counts, inflammation markers, kidney values and sometimes thyroid tests or blood sugar. This is a medical conclusion based on how differential diagnosis and investigation are described in guidelines and overviews.
Sjögren's syndrome cannot be cured - it can be relieved
With the help of the right treatment, symptoms can be relieved and the risk of complications in Sjögren's syndrome can be reduced, but the disease cannot be completely cured today.
Dry eyes: Artificial tears, gel or eye ointment can help. In more severe cases, prescription anti-inflammatory eye drops may be needed.
Dry mouth: Saliva substitutes, sugar-free lozenges and chewing gum can stimulate saliva production.
Dental health: Regular dental visits are important because dry mouth increases the risk of tooth decay, gum problems and fungal infections.
Daily life adjustments: Screen breaks, sunglasses and avoiding dry air or fans on the face can reduce the symptoms.
Systemic disease: If joints, nerves or internal organs are affected, cortisone or immunomodulatory drugs may be appropriate under specialist management.
Early investigation and proper treatment can also reduce fatigue and other symptoms that affect everyday life and work ability.
Do you suspect that your symptoms indicate Sjögren's syndrome?
If you have had dry eyes and a dry mouth on a daily basis for several months, you should seek medical attention. Especially if you also have fatigue, joint pain, swollen salivary glands or an unusually high amount of tooth decay. This also applies if your eyes hurt, your vision is affected or you have difficulty swallowing. Dry mucous membranes may seem harmless, but prolonged dryness deserves a medical explanation.
Samples alone cannot make the diagnosis, but they can provide important clues. Autoantibodies, inflammation tests, blood status and organ-related tests can help determine whether the symptoms indicate an autoimmune process and whether further investigation is needed. For many, it becomes a concrete way to go from uncertainty to the next clear step.
If you already know that you have dry mucous membranes but not why, it is often wise to review the whole picture: medications, blood sugar, thyroid gland, inflammationsmarkörer and autoimmune tests. In some cases, the tests show nothing abnormal, and then it is also valuable information that helps healthcare providers think more broadly.
