Sjogren's syndrome explained: dry eyes, dry mouth and more

What Sjogren's syndrome is

Sjogren's syndrome is an autoimmune condition, meaning the immune system, which normally defends the body against infection, mistakenly attacks the body's own tissues. In this case it targets the glands that produce moisture, especially the tear glands around the eyes and the salivary glands in the mouth. As these glands become inflamed and damaged, they make less fluid, so the eyes and mouth become dry. Sjogren's can occur on its own, called primary Sjogren's, or alongside another autoimmune condition such as rheumatoid arthritis or lupus, called secondary Sjogren's. It is much more common in women than men and usually develops in middle age, though it can occur at any age. It is not contagious and not a cancer, although, as with several autoimmune conditions, there is a small increased risk of certain problems that doctors keep an eye on.

The symptoms it causes

The two hallmark symptoms are dry eyes and a dry mouth. Dry eyes may feel gritty, sore, itchy or as if there is something in them, and can be sensitive to light. A dry mouth can make it harder to chew, swallow and speak, alter taste, and increase the risk of tooth decay and mouth infections. But Sjogren's is more than dryness for many people. Tiredness is very common and can be one of the most troublesome features, along with aching joints and muscles. Some people notice dryness elsewhere, such as a dry nose, throat, skin or vagina. Less commonly, Sjogren's can affect other parts of the body, including the lungs, kidneys, nerves and, rarely, cause swelling of the salivary glands. Because symptoms build slowly and overlap with other conditions, Sjogren's is sometimes overlooked for a while.

How it is diagnosed

Diagnosing Sjogren's syndrome usually involves putting together the pattern of dryness and other symptoms with examination and tests, often led by a specialist such as a rheumatologist, sometimes with help from eye and dental teams. Blood tests can look for inflammation and for particular antibodies that are often, though not always, present in Sjogren's. Simple eye tests measure how much tears the eyes produce and check the surface for dryness. Tests of saliva production and, in some cases, a small biopsy of the tiny salivary glands inside the lip can help confirm the diagnosis by showing the typical inflammation. Because dryness has many causes — including medicines, other conditions and simply ageing — doctors also consider and rule these out. Building this picture allows the team to confirm Sjogren's, check whether other organs are involved, and plan care.

How the dryness is managed

There is no cure, but a great deal helps the symptoms, and much of the care focuses on relieving dryness and protecting the eyes and mouth. For dry eyes, artificial tear drops and lubricating gels are the mainstay, used regularly, along with measures such as taking screen breaks and protecting the eyes from wind and dry air; some people benefit from specialist eye treatments. For a dry mouth, frequent sips of water, sugar-free gum or sweets to stimulate saliva, and saliva substitutes help, and excellent dental care is essential to prevent decay, including regular dental checks and fluoride. Moisturisers, nasal sprays and vaginal moisturisers ease dryness elsewhere. When Sjogren's causes more than dryness — such as significant joint problems or involvement of internal organs — medicines that calm the immune system may be used, guided by a specialist.

Living well with Sjogren's syndrome

Living well with Sjogren's is about steady self-care alongside medical support. Keeping up eye drops and mouth care day to day makes a real difference, as does staying well hydrated and avoiding things that worsen dryness, such as smoky or air-conditioned environments and, where possible, medicines that dry the mouth. Meticulous dental hygiene and regular dental visits protect the teeth. Fatigue can be one of the hardest parts, so pacing activities, gentle regular exercise and good sleep habits help. Because Sjogren's is a long-term condition, regular review allows any new problems to be picked up, and people are advised to report persistent gland swelling, new breathlessness, numbness or other unusual symptoms so these can be checked. Support from patient organisations and connecting with others who have the condition can also help. With good management, most people keep their symptoms under control and maintain a good quality of life.