Sjögren’s Disease

By Linda Rath | Oct. 22, 2025

An international group of doctors and patients met in Rome in 2023 to officially change the name Sjögren (or Sjögren’s) syndrome to Sjögren’s disease (SjD). Rheumatologists, patients and patient advocates cheered the change, saying it’s long overdue. 

The renaming came after years of campaigning by the Sjögren’s Foundation and Sjögren’s patients, who argued that calling it a syndrome made it seem less serious and trivialized the experience of living with it 

A syndrome usually refers to a vague group of recurring symptoms with no clear cause. Sjögren’s disease is an autoimmune disease marked by extreme dryness in parts of the body that are moist in most people. And though the cause isn’t entirely clear, scientists know how it develops: Infection-fighting immune cells, especially B and T cells, attack the normal cells of exocrine glands, which produce moisture in the eyes, mouth and other tissues. This damages the glands, so they’re unable to make the moisture your body needs. B cells are also involved in a rare type of lymphoma that affects mainly people with SjD. 

The committee also changed the classification known as secondary Sjögren’s — implying that it plays second fiddle to another autoimmune disease a person has — to associated Sjögren’s disease. About half of all people with SjD have another autoimmune disease. These changes are more likely to be used in research than in clinical practice, but many patients and providers think they are important. 

Scientists haven’t yet figured out the exact causes of Sjögren’s disease. Many factors are likely involved, including: 

• Genes and environmental triggers. You have a higher risk of developing SjD if a relative has it. About 12% of people have one or more relatives with the disease. Still, something in the environment, such as a viral or bacterial infection, is needed to trigger the disease in people who have genes that put them at risk of it.  
• Gut health. Researchers are also increasingly looking at an imbalanced microbiome as a trigger for SjD. The trillions of bacteria in and on your body, especially your mouth and gut, have been linked to many other autoimmune diseases.  
• Estrogen. The vast majority of people with Sjögren’s disease are women, and researchers believe the hormone estrogen might play a role. Women are more likely to develop it after age 40, when estrogen levels start dropping.

The severity of Sjögren’s disease varies. For some patients, symptoms are troubling but relatively mild. Others have symptoms that wax and wane or even go into remission. And some have chronic symptoms that can be debilitating.  

Dry eyes, dry mouth, fatigue and joint pain are the most common signs of SjD, but the disease can also affect other parts of the body, including the liver, kidneys, pancreas, lungs, nervous system and digestive tract. Overall, Sjögren’s may lead to: 

• Brain fog and headaches 
• Dry eyes and eye infections 
• Chronic sinusitis 
• Mouth sores, cavities, swollen salivary glands, trouble chewing or swallowing 
• Extremely dry skin 
• Light sensitivity 
• Frequent pneumonia 
• Raynaud’s disease 
• Irritable bowel 
• Vaginal dryness 
• Lymphoma 

Sjögren’s disease is challenging to diagnose because symptoms don’t all happen at once, and doctors may treat specific symptoms without realizing they all are due to a single disease. Plus, other conditions have similar symptoms, so it can take an average of about three years to get a correct diagnosis — down from about six years a decade or so ago.  

No one test can diagnose SjD, so you may have a combination of blood, eye and dental tests and in some cases a salivary gland biopsy. 

• Blood tests. Some people have certain proteins in their blood called autoantibodies, and some blood tests can detect them. The anti-SSA (also called anti-Ro) or anti-SSB (also called anti-La) blood tests are the most specific ones for Sjögren’s disease. About 70% of people who have SjD are positive for anti-SSA and 40% are positive for anti-SSB. These tests can also be positive in patients who have lupus.   
• Dry eye tests. A test called a Schirmer test is used to tell how well your eyes produce tears. A slit-lamp test checks the surface of the eye (cornea) for dryness-related damage.  
• Saliva tests. These tests measure saliva output over a certain period of time. 

There is no cure yet for Sjögren’s disease (although three are currently in phase 3 clinical trials) and no therapies that slow or stop the disease itself. Treatment focuses on managing symptoms with a combination of lifestyle changes, over-the-counter medications and prescription drugs.  

For Inflammation and Pain: 

• Nonsteroidal anti-inflammatory drugs (NSAIDs). The first treatment usually recommended for SjD, NSAIDs are common, over-the counter pain relievers like aspirin, ibuprofen (Motrin) and naproxen (Aleve). Doctors sometimes recommend prescription versions. (Be aware that even over-the-counter NSAIDs can cause stomach bleeding and ulcers, especially when taken long-term.)  
• Corticosteroids. These can stop a flare or severe symptoms quickly, but they can have many serious side effects. Although they’re often prescribed briefly for SjD, doctors usually try to find other options for long-term use. 
• Disease-modifying anti-inflammatory drugs (DMARDs). These drugs calm an overactive immune system. More than a decade ago, the Sjögren’s Foundation and American College of Rheumatology issued treatment guidelines for SjD. According to the guidelines, there was little evidence for using DMARDs for SjD, but hydroxychloroquine might be helpful for joint pain and rashes. Hydroxychloroquine can cause eye damage, so it’s crucial to see an eye doctor two or three times a year if you take it. 

For Dry Eyes: 

• Over-the-counter artificial tears like Refresh, and Oasis Tears Plus and FreshKote, which uses a newer technology to stabilize all three tear layers 
• Prescription eye treatments like Restasis and CEQUA  

For Dry Mouth: 

• Over-the-counter saliva substitutes or mouth-coating gels, like Glandosane and MouthKote 
• Prescription medications that stimulate saliva flow, such as pilocarpine and cevimeline. If you have asthma or narrow-angle glaucoma, ask your doctor if it’s safe to take these medications. Your doctor may also prescribe Aquoral mouth spray or NeutraSal mouth rinse. 

For Vaginal Dryness:  

Water-based vaginal lubricants (K-Y Jelly, Astroglide, Replens, Luvena) can ease vaginal dryness and painful intercourse. Estrogen creams or other preparations may be helpful for post-menopausal women who have vaginal dryness due to reduced estrogen levels. Avoid using Vaseline or other oil-based lubricants, which can lead to infections.  

Taking a proactive role in your treatment is one of the best ways to help manage Sjögren’s symptoms. 
 
For Dry Mouth and Dental Health 

• Take small sips of water throughout the day.  
• Chew sugar-free gum or suck on sugar-free hard candies or lozenges such as Dentiva to stimulate saliva flow.  
• Use products that contain the artificial sweetener xylitol to help prevent tooth decay.  
• Have frequent dental checkups.  
• Use an electric toothbrush.  
• Brush and floss teeth regularly, especially after meals. If daytime brushing isn't possible, rinse with plain water.  
• Avoid sugar-containing food and drinks between meals.  

For Dry Eyes 

• Use eye drops on a regular basis; try single-unit preservative-free drops.  
• Limit the use of drops with preservatives, which can cause dryness and irritation.  
• Use lubricating eye ointments or gels at night.  
• Use wraparound sunglasses or moisture shields that attach to glasses to prevent loss of moisture from the eyes.  

For Dry Nose, Throat and Upper Airways 

• Use nasal sprays of water or saline during the day. In some climates, using a home humidifier may help.  
• Use water-based nasal gels at nighttime.  

For Joint Pain 

Rest joints when they are swollen and painful to reduce inflammation and fight the fatigue that can come with a flare. To relieve joint stiffness and improve range of motion, exercise between flares. An exercise program should emphasize aerobic conditioning, muscle strengthening and flexibility.