All Dried Up with Sjogren's?

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Category: Other Autoimmune Diseases Published on Monday, 01 August 2005 Written by Yong Tsai, MD
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Linda, a 45-year-old woman with rheumatoid arthritis that is affecting her hands and feet, wondered why she was always thirsty and had to blink all the time. Why were here eyes and mouth so dry?

Sjogren’s syndrome is an autoimmune disease (immune system turns against our body cells) which occurs when lymphocytes (white blood cells) attack the lacrimal (tear) and salivary (saliva) glands that provide a natural protective lining for the mouth, teeth, gums, and eyes.

Saliva and tears keep the mouth, throat, and eyes moist and in god condition. However, when these glands are damaged, lack of moisture can cause the mouth and eyes to become dry. The main symptoms of Sjogren’s syndrome are dry eyes and a dry mouth and commonly parotid (jaw area) gland swelling.

Your eyes may become red, sensitive to light, burn. Itch, and feel like they are full of sand. Also, you may experience difficulty swallowing, speaking, and tasting because your mouth is so dry.

Whether Sjogren’s syndrome is a primary, occurring by itself, or secondary condition, with another disease such as rheumatoid arthritis or lupus, it can also affect other body parts, such as joints, the nervous system, the kidneys, the lungs, and the skin. Such involvement can cause symptoms such as joint pain, dry cough, vaginal dryness, or numbness and tingling in the arms and legs. Sjogren’s has affected one to four million people, 90 percent of whom are women. It can occur at any age, but is rare in children.

Specific antinuclear antibodies called SS-A and SS-B, as well as ANA (anti-nuclear antibody) and RF (rheumatoid factor) are prevalent in Sjogren’s syndrome. At present, there is no wonder drug available as a cure. However, symptoms can be treated with methods such as using artificial tears for dry eyes.

Salivary glands can be stimulated to produce more saliva by chewing gum, sipping water often throughout the day, or in more severe cases, using saliva substitutes to keep your mouth moist. Since natural saliva has the capability of ridding the mouth of infection and cavity-causing-bacteria, good oral hygiene is extremely important.

There are two drugs available that stimulate the salivary glands to produce saliva: pilocarpine (Salagen) and cevimeline (Evoxac). Another new drug, RESTASIS, that recently received FDA approval for dry eyes, will be available soon. Lastly, punctual occlusion, a surgery performed in severe case of dry eyes, seals the tear duct that releases tears from the eye.

Because there are many causes for dry eyes and a dry mouth, your doctor must take other possible causes into account. However, with the help of certain blood tests and new medications, you can rain on Sjogren’s parade and replenish your mouth and eyes.

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