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Sjögren's (pronounced Show-grin's) syndrome is a condition that affects parts of the body that produce fluids like tears and spit (saliva).
It usually starts in people aged 40-60 and is much more common in women than men.
It's a long-term condition that can affect your daily life, but there are treatments to help relieve the symptoms.
This page covers:
Symptoms of Sjögren's syndrome include:
Read more about the symptoms of Sjögren's syndrome.
See your GP if you have symptoms of Sjögren's syndrome that don't go away or are bothering you.
If needed, they can refer you to a specialist for further tests, such as:
Read more about the tests for Sjögren's syndrome.
There's currently no cure for Sjögren's syndrome, but there are things you can do to help relieve your symptoms.
There are also several treatments that can help, such as:
Read more about treatments for Sjögren's syndrome.
Sjögren's syndrome is caused by the immune system – the body's defence against illness – damaging healthy parts of the body. This is what's known as an autoimmune condition.
The bits of the body usually affected are those that produce fluids like tears and saliva. But other parts of the body, such as nerves and joints, can also be affected.
It's not clear why the immune system stops working properly. It may be linked to:
Sjögren's syndrome can occur with other autoimmune conditions like rheumatoid arthritis or lupus. This is known as secondary Sjögren's syndrome. Primary Sjögren's syndrome is where you don't have any other related conditions.
Sjögren's syndrome is a long-term condition that doesn't tend to get better on its own, although the symptoms can often be treated.
For some people the condition may just be a bit of a nuisance, while for others it can have a big impact on their everyday life.
If you're diagnosed with Sjögren's syndrome, ask your doctor about what you can expect.
You may also find it useful to contact organisations such as the British Sjögren's Syndrome Association (BSSA) for advice and support.
The main symptoms of Sjögren's syndrome are dry eyes and a dry mouth, but it can also cause several other problems.
Each person is affected differently. For some people the condition may just be a bit of a nuisance, while for others it can have a big impact on their everyday life.
There are many conditions that can cause similar symptoms. See your GP if you have any symptoms you're worried about.
Signs that you may have dry eyes include:
These symptoms may be worse when the air is dry – for example, when you're somewhere that's windy, smoky or air conditioned.
Dry eyes can be caused by many conditions besides Sjögren's syndrome. Read more about the causes of dry eyes.
Signs that you may have a dry mouth include:
Sjögren's syndrome can also cause a range of other problems.
These can include:
Some people have other conditions closely linked to Sjögren's syndrome too, such as Raynaud's phenomenon, a condition that affects the blood supply to the fingers and toes.
Read more about the complications of Sjögren's syndrome.
See your GP if you have symptoms of Sjögren's syndrome. They'll ask about your symptoms and look at your eyes and mouth to check for any obvious problems.
But as there are many conditions with similar symptoms to Sjögren's syndrome, it can be very difficult for your GP to diagnose.
They can refer you to a specialist for further checks if needed.
The main tests used to diagnose Sjögren's syndrome are:
Blood tests can be done to look for antibodies in your blood. Antibodies are substances produced by your immune system (the body's defence against illness and infection) to attack germs.
In Sjögren's syndrome, the immune system produces antibodies that attack healthy areas of the body. These can be found during a blood test.
But not everyone with Sjögren's syndrome has these antibodies, so you may still have the condition even if a blood test doesn't find them.
An eye doctor (ophthalmologist) may carry out a test to look at the layer of tears that forms across the front of your eyes.
This involves harmless coloured drops being placed in your eyes to make the layer of tears easier to see for a short time. Your doctor then looks at your eyes using a special microscope with a light.
If the layer of tears is very patchy, it could be a sign of Sjögren's syndrome.
In people with Sjögren's syndrome, clumps of white blood cells, which are produced by the immune system, can form inside the cells where spit (saliva) is produced.
To check for this, a very small piece of tissue from the inside of your lip may be removed and looked at under a microscope. This is known as a lip biopsy.
Local anaesthetic is injected into your lip to numb it for the procedure.
Occasionally, some other tests may be carried out. These may include:
Producing less saliva or fewer tears than normal can be a sign of Sjögren's syndrome.
There's currently no cure for Sjögren's syndrome, but there are treatments that can help relieve the symptoms.
This page covers:
If you have dry eyes, it can help to:
You can also try eye drops and ointments that help keep your eyes wet, sometimes known as artificial tears.
There are several different types of drops that can be bought from pharmacies without a prescription. You may need to try a few types to find one that works for you.
If you use eye drops more than three times a day, avoid drops that contain preservatives as these can damage your eyes if used frequently.
If the surface of your eye is irritated (inflamed), your doctor may prescribe drops containing steroids to use for a short period.
Sometimes other anti-inflammatory drops, such as ciclosporin drops, may be prescribed by an eye specialist.
If self-help measures and eye drops aren't helping, your doctor may recommend:
If you have a dry mouth, it can help to:
There are also products you can buy from pharmacies that help keep the mouth moist – known as saliva substitutes.
There are several different types available, including sprays, lozenges (medicated sweets) and gels. You may need to try a few types to find one that works for you.
But these products don't help prevent mouth infections in the same way that saliva does, so it's still important to practise good oral hygiene.
The medicine pilocarpine can be used to treat a dry mouth and eyes. It comes as tablets that help the body produce more saliva and tears.
But it isn't suitable for everyone and can cause some side effects, such as sweating, headaches, and needing to pee more often than normal.
If your doctor recommends pilocarpine, talk to them about the benefits and risks of taking it.
If you have dry skin, it may help to use a moisturising cream (emollient) every day.
It's also a good idea to avoid strong, perfumed soaps. Use emollient soap substitutes instead.
Read more about emollients and soap substitutes.
Treatments for vaginal dryness include:
Read more about treatments for vaginal dryness.
If you have pain or stiffness in your joints or muscles, it can help to:
A medication called hydroxychloroquine is sometimes recommended by Sjögren's syndrome specialists as a treatment for joint pain or stiffness if other methods haven't helped.
But it isn't suitable for everyone and can take several months to work. It can also cause side effects such as tummy pain and feeling sick.
Sjögren's syndrome can sometimes lead to further problems or occur alongside other conditions.
If you have very dry eyes and they're not treated, there's a risk the front layer of your eyes could become damaged over time.
If this isn't spotted and treated, it could lead to permanent problems with your vision.
Contact your GP as soon as possible if you have problems with your vision.
Sometimes Sjögren's syndrome can affect the lungs and cause problems such as:
If you smoke, stopping may help reduce the risk of these conditions. Read more advice about stopping smoking.
Most women with Sjögren's syndrome can get pregnant and have healthy babies.
But if you're planning a pregnancy, it's a good idea to get advice from your GP or specialist because there's a small risk of complications in some women.
These problems can occur if you have certain antibodies (produced by the immune system) sometimes found in people with Sjögren's syndrome. A blood test can be done to look for these.
If these antibodies are found, you can still get pregnant, but you may need additional specialist care during pregnancy and after the birth.
People with Sjögren's syndrome have an increased risk of developing a type of cancer called non-Hodgkin lymphoma.
This affects the lymphatic system, a network of vessels and glands found throughout the body.
Research suggests people with Sjögren's syndrome are about five times more likely to get non-Hodgkin lymphoma than those who don't have the condition, but the chances of getting it are still small.
See your GP if you develop symptoms of non-Hodgkin lymphoma, such as:
Non-Hodgkin lymphoma can often be cured if it's caught early on.
A number of other conditions have been linked to Sjögren's syndrome, including: