Sjogren's disease (SjD)

Sjögren's disease, also known as SjD or Sjögren's syndrome, is an autoimmune disorder. This is when your immune system attacks your own healthy cells and tissue by mistake.

If you have Sjögren's disease, it usually affects the glands that produce: 

• tears
• saliva 
• sweat

Other parts of your body may also be affected, such as your lungs.

In the past, Sjögren's disease was called Sjögren's syndrome and was classified as:

• primary Sjögren's syndrome — when you develop Sjögren's disease alone
• secondary Sjögren's syndrome — when you develop Sjögren's disease as well as another autoimmune disease, such as lupus or rheumatoid arthritis 

The term Sjögren's disease is now more commonly used — this recognises that the condition can overlap with other autoimmune diseases. 
Sjögren’s disease affects people in different ways. Many people can manage their symptoms well, but some may develop complications and need ongoing medical care.

If you have Sjögren's disease, you will often have:

• dry eyes — this may also feel like burning or itchiness 
• a dry mouth — this may make it difficult to swallow, speak or eat dry foods

Some people with Sjögren's disease also notice:

• joint pain, swelling and stiffness
• dry skin in their nose or throat
• vaginal dryness
• persistent dry cough
• ongoing fatigue
• tooth decay
• skin rashes

Sjögren's disease can affect other parts of your body as well:

• Liver — this may cause fatigue (tiredness) or jaundice (yellowing of the skin) 
• Kidneys — this may cause fatigue and dehydration
• Blood vessels — inflammation may lead to vasculitis
• Lymph nodes).

The symptoms of Sjögren's disease can have a significant impact on your quality of life and make basic daily activities more difficult. Talk with your doctor about how to best manage the symptoms of Sjögren's disease.

The exact cause of Sjögren's disease is unknown. However, it’s more common in:

• females
• people over 40 years of age
• people with a family history of other autoimmune conditions

Some factors may mean you are more likely to develop Sjögren's disease, such as:  

• genetic abnormalities
• viral infection
• stress 
• hormone changes, such as during puberty or pregnancy 

If you experience symptoms of Sjögren's disease you should see your doctor. This includes:

• dry eyes
• dry mouth
• swelling of the glands in the face and neck areas

The sooner you begin treatment, the more likely it is to help.

If you are diagnosed with Sjögren's disease your doctor may recommend regular check-ups. This is to monitor for possible complications.

In order to diagnose Sjögren's disease, you doctor will ask you questions about your symptoms and examine you.

Your doctor may also refer you for tests such as:

• Schirmer's test — to check whether the eyes are producing enough tears
• a blood test — to check for antibodies common in people with Sjögren's disease
• imaging of your salivary glands — to see how well your salivary glands are working
• a biopsy of your salivary gland or lip — a small piece of tissue is sent to a laboratory for testing 
• an ocular staining test — uses dyes to detect damage to the surface of your eyes

There is no cure for Sjögren's disease, however there are treatments available to help manage your symptoms.

Self-care at home

Here are some tips to help manage your symptoms. 
If you have dry eyes, you can:

• use artificial tears or an eye lubricant
• put on eyewear to protect you from exposure to the wind or sun
• have regular check-ups with an ophthalmologist (eye specialist)

If you have a dry mouth, it may help to:

• have frequent sips of water
• use artificial saliva, a mouth rinse or sugarless gum
• limit your sugar intake 
• brush your teeth at least twice a day with a fluoride toothpaste
• have regular check-ups with a dentist

To manage general dryness, you can:

• increase indoor humidity, where possible
• use preservative-free moisturiser for your skin and lips
• avoid drying conditions such as heaters and air conditioners
• avoid exposure to dusty or windy weather

Medicines for Sjogren’s disease

If your symptoms become worse despite self-care measures, your doctor may prescribe medicines to help. This may include:

• short term use of corticosteroid eye drops 
• a saline nasal spray 
• paracetamol or non-steroid anti-inflammatory drugs (NSAIDs) 
• medicines such as pilocarpine to increase the amount of tears you produce
• immunosuppressant medicines 

Other treatment options

If other options have not worked or are not suitable for you, your doctor may recommend permanent punctal occlusion. This is a surgery to help keep your eyes moist. It works by reducing the drainage of tears from your eyes.

No matter how you manage your symptoms, it’s important to see your doctor for regular reviews.

Because Sjögren's disease can affect multiple parts of your body, there are a variety of possible complications, including:

• dental problems
• oral thrush
• vision problems
• inflammation of your internal organs such as your kidneys, lungs or liver
• problems with your nervous system
• depression

A small number of people with Sjögren’s disease may develop lymphoma (a cancer of the lymphatic system). Your doctor may monitor your health over time to check for this and other less common complications.

Sjögren's disease can’t be prevented, but there are things you can do to prevent your symptoms from getting worse.

You should avoid medicines that may make eye dryness worse, such as:

• antihistamines (medicines for allergies and allergic reactions)
• diuretics (medicines to help your kidneys produce more urine)

You should avoid medicines that can make dry mouth worse. This includes some:

• antidepressants (medicines used to treat mental health conditions such as depression)
• stimulant drugs (a class of drugs that may make you feel more alert or energetic)
• bronchodilators (medicines commonly used for asthma)

It’s also best to quit or reduce smoking and vaping.

It’s important to see your doctor regularly to get the best care and to prevent complications.

Visit the Arthritis Australia (Opens in new tab) page for more information on the symptoms and management of Sjögren’s disease (Opens in new tab).

The Australasian Society of Clinical Immunology and Allergy (ASCIA) (Opens in new tab) page answers some frequently asked questions on Sjögren’s disease (Opens in new tab).