What is Sjögren's Syndrome?
Sjögren's syndrome is a chronic autoimmune condition in which the immune system attacks moisture-producing glands throughout the body — particularly the tear glands (lacrimal glands) and salivary glands. This leads to the hallmark symptoms of dry eyes and dry mouth. It can occur on its own (primary Sjögren's) or alongside other autoimmune conditions such as lupus or rheumatoid arthritis (secondary Sjögren's).
Sjögren's syndrome is more common in women (nine times more than men) and typically develops after the age of 40.
Symptoms
- Dry eyes — gritty, burning, or itchy sensation
- Dry mouth — difficulty swallowing or speaking
- Fatigue — often severe
- Joint pain and stiffness
- Swollen salivary glands
- Skin dryness
- Vaginal dryness
- Dental problems — dry mouth increases cavity risk
- Nerve problems (peripheral neuropathy)
Treatment
There is no cure for Sjögren's, but symptoms can be managed:
- Eye drops and gels — artificial tears for dry eyes
- Saliva substitutes and stimulants for dry mouth
- Hydroxychloroquine — reduces fatigue and joint pain
- NSAIDs for joint pain
- Immunosuppressants for severe cases
- Good dental hygiene and regular dental check-ups
More than dry eyes and mouth
Dryness is the best-known feature of Sjögren's, but for many people the tiredness is just as hard to live with. Joint and muscle aches are common, and some people have Raynaud's, dry skin, a dry cough, vaginal dryness, swollen glands in the cheeks or under the jaw, or numbness and tingling from nerve involvement. Symptoms vary a lot between people and can come and go.
How Sjögren's is diagnosed
There is no single test. A rheumatologist puts together your symptoms with other checks, which may include blood tests for particular antibodies (such as anti-Ro and anti-La), tests of tear production and eye surface health carried out by an eye specialist, measurement of saliva flow, and sometimes a small biopsy from the inside of the lip. Because symptoms overlap with lots of other causes of dryness, including menopause, some medicines and ageing, getting a diagnosis can take time.
Looking after dry eyes
Lubricating eye drops, gels and ointments are the mainstay. Preservative-free drops are often recommended if you use them many times a day. Gels or ointments at night can help if you wake with sore eyes.
- Keep screens slightly below eye level and remember to blink fully.
- Avoid sitting in draughts from fans, air conditioning or car vents.
- Try wraparound glasses outdoors on windy days.
- Ask your optometrist or GP about warm compresses and lid hygiene.
- See an optician or eye service promptly for eye pain, light sensitivity or blurred vision that does not clear with blinking.
Looking after a dry mouth and teeth
Saliva protects teeth, so a dry mouth raises the risk of tooth decay, gum problems and mouth infections such as thrush.
- Sip water regularly and keep a bottle by the bed.
- Try saliva substitutes, gels or sprays, or sugar-free gum or lozenges to stimulate saliva.
- Use a high-fluoride toothpaste if your dentist recommends one, and see your dentist and hygienist regularly.
- Cut back on sugary snacks and acidic drinks between meals.
- Tell your dentist and pharmacist that you have Sjögren's.
Treatment for the whole body
When joint pain, fatigue or other body-wide symptoms are a problem, a rheumatologist may suggest hydroxychloroquine, which needs regular eye checks, or other medicines for more serious organ involvement. Pacing, regular gentle exercise and good sleep habits help many people with fatigue. Medicines that cause dryness as a side effect are worth reviewing with your GP or pharmacist, but do not stop any prescribed medicine without advice.
When to seek medical advice
Tell your GP or rheumatology team about new or worsening symptoms. See a doctor promptly if a gland in your cheek, jaw or neck stays swollen for weeks, if you notice a new lump, unexplained weight loss or night sweats, or if you have persistent numbness, breathlessness or a new rash. Most of these have simple explanations, but they should be checked.
About this page
Written by Louis Maxwell, First Contact Practitioner (HCPC PH128483), and pending clinical review. This is general information, not a diagnosis. Always follow the advice of your own GP, physiotherapist or rheumatology team. For emergencies call 999; for urgent advice use NHS 111.