Although there is no cure yet, there are ways to ease symptoms
Sjögren’s disease affects everyone differently. Treatment is tailored to each individual’s symptoms and health profile.
Goals of treatment include:
- Alleviating dryness (eyes, mouth, skin, etc.)
- Managing fatigue and joint pain
- Preventing complications
- Supporting immune health
Schirmers Test
This is an ophthalmology test used to detect severe dryness and dysfunction of the Lacrimal glands. This test involves placing a small strip of sterile filter paper inside the lower eyelid of each eye. The patient closes the eye and the strips are left in place for 5 minutes. The amount of moisture that has soaked the strip is measured in mm. Normal tear production is more than 10-15mm of moisture. Mild to moderate dryness is 5-10mm. Severe dryness is less than 5mm
Ocular staining
A special dye is added to the eyes to highlight areas where the cornea or conjuctive have been damaged due to lack of adequate tear production or poor tear film quality.
Unstimulated whole salivary flow rate test
May be undertaken by a Dentist or oral medicine practitioner. This process tests how long it takes for the minor salivary glands to produce droplets, along with viscosity and pH of unstimulated saliva. A patient may also be asked to chew a piece of wax for 5 minutes and the amount of saliva produced is measured and tested.
Lip Biopsy (Minor Salivary Gland Biopsy)
A lip biopsy is a common diagnostic method, particularly for patients who test negative for SSA/Anti-Ro. It is the current gold standard test, and false positives and false negatives can occur.
Laboratory Tests to Support a Sjögren’s Diagnosis
There are several laboratory tests that can help support a diagnosis of Sjögren's, although there is no single test that can diagnose Sjögren's disease.
Immunoglobulin tests
The immunoglobulin quantitation test measures the levels of the most common types of immunoglobulins in the blood, known as IgG, IgM, and IgA.
Dry eyes
- Artificial tears and gels
- Cyclosporine eye drops
- Punctal plugs
- Omega-3 supplements
Dry mouth
- Saliva substitutes and enhancers
- Sugar free gum
- Pilocarpine
- Regular dental visits
Joint and muscle pain
- NSAID eg. ibuprofen
- Hydroxychloroquine (Plaquenil)
- Physical Therapy
- Gentle Excercise
Systemic treatments
- Immunosuppressants
- Corticosteroids (short term)
- Biologics
- Off label treatments (Based on medical advice only)
- IVIG for neuropathies
Fatigue & Mental Health
- Hydroxychloroquine (plaquenil)
- Low dose Naltrexone
- Antidepressants
- Cognitive support therapy
- Maintain good sleep hygiene
Dry skin and body
- Emollient rich moisturisers
- Systemic pilocarpine
- Hormonal gel
- Lubricants
Complementary & integrative approach
While not a replacement for medical treatment, many people with Sjögren's disease find additional relief and wellbeing through evidence informed complementary therapies. Always discuss with your healthcare team.
Mind body techniques
- Mindulness meditation
- Breathing excercises
- Cognitive behavioural therapy
- Yoga and Tai Chi
Diet & gut health
- Anti inflammatory diet
- Whole foods based diets
- Probiotics
- Reduced sugar intake
- Stay well hydrated
Supplements & natural support
- Vitamin D and K2
- Magnesium
- Fish oil & Omega 3's
- Evening primrose oil
Body work
- Acupuncture
- Myotherapy
- Remedial massage
- Regular physiotherapy
- Dry needling