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Sjögren’s and Your Body

This autoimmune disease, which primarily affects the eyes and mouth, can involve other organs and systems that require a variety of treatments.

By Mary Anne Dunkin

Most people, if they’re familiar with Sjögren’s at all, think of it as a disease that makes the mouth dry and the eyes gritty. That is true, but it can also affect the skin, joints, mucous membranes and respiratory system. In addition to medications, there are simple self-care tips you can use for managing the symptoms of Sjögren’s.

Mouth

Dry mouth can be more than uncomfortable. Without the protection saliva offers, you may experience tooth decay, mouth pain, oral infections and difficulty swallowing.
Many people get the relief they need from artificial saliva products. Also helpful are toothpastes and mouth rinses developed specially for dry mouth.
 
Tips for relieving a dry mouth:
  • Keep a water bottle with you and sip throughout the day.
  • Suck on sugar-free candy or lozenges or chew sugar-free gum.
  • Avoid using drugs such as antihistamines and antidepressants that cause dryness, if possible.
  • Avoid mouthwashes with alcohol, which can worsen dryness.
  • Try vaginal lubricants as an inexpensive alternative to oral lubricants that is available in almost any pharmacy or discount store.  Although they aren't marketed for oral use, the FDA requires safety testing for vaginal lubricants and the risk of side effects is small.
     

Eyes

Untreated dry eyes can damage the eye’s surface, increase the risk of infection and even impair vision. If you suffer from dry eyes, artificial tears may help restore moisture.

Tips for easing dry eyes:
  • Avoid sitting next to air conditioners or heaters. Adjust the fans in your car so that air does not blow directly on your face.
  • Use a humidifier in your bedroom at night.
  • Make a conscious effort to blink throughout the day, especially if you work at computer.
  • Take a break during the day to close your eyes and relax. Cover your eyes with a warm washcloth.
  • Eat more fish. Research shows that omega-3 fatty acids found in cold water fish eases dry eyes.

Esophagus

Saliva helps neutralize the acidity of gastric acids. When it is lacking, you may experience heartburn. Taking non-steroidal anti-inflammatory drugs (NSAIDs) to relieve other Sjögren’s symptoms can also worsen the problem.

Tips for relieving heartburn:
  • Eat smaller, more frequent meals.
  • Note which foods tend to worsen heartburn and avoid those when possible. Common culprits include fatty foods, citrus fruits and juices, chocolate and caffeine.
  • Avoid eating for at least two hours before going to bed at night so the stomach has a chance to empty and acid levels decrease before you lie down.
  • Elevate the head of your bed on two-inch blocks to keep gastric acid from washing back into your esophagus while you sleep.

Upper Respiratory System

If your nasal passages are dry, as they can be with Sjögren’s, you may feel you’re constantly battling sinusitis and post-nasal drip. Sjögren’s patients can have longer-lasting infections than those without the syndrome, and that they have a higher chance of persisting with post-nasal drip and cough or of these developing into bronchitis or pneumonia.

Tips for moisturizing and protecting dry nasal passages:
  • Use a humidifier or vaporizer.
  • Make and use your own saltwater spray by mixing one teaspoon of salt in one quart of deionized water and boiling to fully dissolve the salt.
  • Drink plenty of fluids to thin your mucus.
  • Avoid drinking alcohol, which can dry out your nasal passages.
  • Avoid chlorinated swimming pools, because chlorine can irritate nasal passages.
  • Apply warm, wet towels to your face.

Skin

Dry skin that cracks and itches is common with Sjögren’s. The lips are also frequently affected. In some people, Sjögren’s is associated with skin rashes. These first appear most often as areas of dark blotches on the legs and feet that grow together.

Tips for moisturizing skin:
  • Limit showers to five minutes, because water removes the skin’s natural oils.
  • When drying the skin with a towel, pat, do not rub.
  • Apply creams and lotions after a shower or bath when your skin is still moist.
  • For between-shower application, dampen your skin with a wet towel before applying lotion.
  • Use a humidifier in your bedroom at night to help moisten your skin.

Vagina

Vaginal dryness can make intercourse painful and interfere with sexual relationships.

Tips for moisturizing the vagina:
  • Use vaginal moisturizers and lubricants.
  • Avoid scented body washes or bubble baths that can irritate the inside of the vagina.
  • Prolong foreplay so that your vagina has more time for natural lubrication.

Joints

Sjögren’s may be associated with joint pain and inflammation itself, or it may accompany an inflammatory form of arthritis, such as rheumatoid arthritis or lupus.

Tips for easing joint pain:
  • Apply heat or cold (or alternate the two) to painful joints with warm washcloths or a bag of ice or frozen vegetables wrapped in a towel.
  • Speak to your doctor or physical therapist about exercises to keep joints mobile, relieve stiffness and improve range of motion.
  • Rest painful or swollen joints. 
  • Use assistive devices to spare joints that are inflamed.

Lungs

In some people with Sjögren’s, a bout with the flu or a sinus infection can leave dried mucus that obstructs the upper airways, causing a dry cough and potentially leading to pneumonia.

Sometimes the inflammatory process of Sjögren’s affects the walls of tiny balloon-like airs sacs (alveoli) in the lungs, where oxygen is added to your blood and the waste product carbon dioxide is removed.

This inflammation can cause the interstitium, the tissue that lines and supports the sacs, to thicken and scar – a problem known as interstitial pneumonitis or interstitial lung disease. This thickening makes it more difficult for oxygen to enter the bloodstream, causing shortness of breath. Interstitial pneumonitis may not show up on a routine chest X-ray. If your doctor suspects this problem, she may order a high-resolution CT scan to look for inflammation.

Tips for managing an upper respiratory infection:
  • Drink plenty of fluids to stay well hydrated, which may help prevent the development of pneumonia.
  • Use a humidifier or vaporizer in your room.
  • Try a sinus rinse or neti pot, an at-home procedure that uses salt water to remove mucus and debris from the nasal passages and sinuses.
While it is important to be aware that Sjögren’s can affect your entire body, doctors caution that just because you experience a symptom, you cannot assume Sjögren’s is the cause. The best course of action is to see a doctor who can help determine the cause of troublesome symptoms and the best treatment for them.
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