What is the treatment for Sjögren's syndrome? Will changes to one's diet improve Sjögren's syndrome symptoms and signs?
The treatment of patients with Sjögren's syndrome is directed toward the particular areas of the body that are involved and prevention of complications such as infection. There is no cure for Sjögren's syndrome.
Dryness of the eyes can be helped by artificial tears, using eye-lubricant ointments at night, and minimizing the use of hair dryers. When dryness becomes more significant, the ophthalmologist can plug the tear duct closed so that tears cover the eye longer. Cyclosporine eyedrops (Restasis) are approved medicated eyedrops that can reduce the inflammation of the tear glands, thereby improving their function. Signs of eye infection (conjunctivitis), such as pus or excessive redness or pain, should be evaluated by the doctor. Dietary addition of flaxseed oil may also benefit eye dryness. Vitamin D supplementation may be beneficial, especially in those who have insufficient vitamin D blood levels.
The dry mouth can be helped by drinking plenty of fluids, humidifying air, and good dental care to avoid dental decay. The glands can be stimulated to produce saliva by sucking on sugarless lemon drops or glycerin swabs. Additional treatments for the symptom of dry mouth are prescription medications that are saliva stimulants, such as pilocarpine (Salagen) and cevimeline (Evoxac). These medications should be avoided by people with certain heart diseases, asthma, or glaucoma. Artificial saliva preparations can ease many of the problems associated with dry mouth. Many of these types of agents are available as over-the-counter products, including toothpaste, gum, and mouthwash (Biotene). Numoisyn Liquid and lozenges are also available for the treatment of dry mouth. Vitamin E oil has been used with some success. Infections of the mouth and teeth should be addressed as early as possible in order to avoid more severe complications. Diligent dental care is very important. Moist, warm compresses can be massaged onto the parotid glands to help relieve swelling and pain.
Saltwater (saline) nasal sprays can help dryness in the passages of the nose. A woman should consider vaginal lubricant for sexual intercourse if vaginal dryness is a problem.
Hydroxychloroquine (Plaquenil) has been helpful for some manifestations of Sjögren's syndrome, particularly fatigue, and muscle and joint pains. Serious complications of Sjögren's syndrome, such as vasculitis, can require immune-suppression medications, including cortisone (prednisone and others) and/or azathioprine (Imuran) or cyclophosphamide (Cytoxan).
Infections, which can complicate Sjögren's syndrome, are addressed with appropriate antibiotics. Cancer of the lymph nodes (lymphoma), a rare complication of Sjögren's syndrome, is treated independently.