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World Sjögren’s Day

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What is Sjögren’s?

Sjögren’s (“SHOW-grins”) is a systemic autoimmune disease that affects the entire body. Along with symptoms of extensive dryness, other serious complications include profound fatigue, chronic pain, major organ involvement, neuropathies, and lymphomas.
Although many patients experience dry eye, dry mouth, fatigue and joint pain, Sjögren’s can also cause dysfunction of organs such as the gastrointestinal system, blood vessels, lungs, liver, kidney, pancreas, and the central nervous system. Patients also have a higher risk of developing lymphoma, and heart block can occur in fetuses when a mother has Sjögren’s. Today, as many as four million Americans are living with this disease. Sjögren’s may occur alone or in the presence of another connective tissue disease such as rheumatoid arthritis, lupus, or scleroderma. All instances of Sjögren’s are systemic, affecting the entire body. Symptoms may plateau or worsen overtime.
While some people experience mild discomfort, others suffer debilitating symptoms that greatly impair their functioning. That is why early
diagnosis and proper treatment are important — as these may prevent serious complications and greatly improve a patient’s quality of life.

What are the symptoms someone may notice before getting diagnosed?

Presenting symptoms vary from person to person but some of the most common symptoms patients may experience include:

  • Dry, gritty, or burning sensation in the eyes
  • Increased dental decay
  • Dry mouth symptoms including difficulty talking, chewing, or swallowing
  • Dry or burning throat or mouth
  • Joint or musculoskeletal pain
  • Sore or cracked tongue
  • Vaginal and skin dryness
  • Digestive problems, including reflux
  • Neuropathies
  • Profound fatigue

In addition, Sjögren’s may accompany other autoimmune diseases such as lupus, rheumatoid arthritis, and scleroderma. Physicians should also take note that not all patients will present with symptoms of dryness.

Is it easy to diagnose Sjögren’s?

Sjögren’s can be challenging to recognize or diagnose because symptoms of Sjögren’s may mimic those of menopause, drug side effects, or medical conditions such as lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, multiple sclerosis. Because all symptoms are not always present at the same time and because Sjögren’s can involve several body systems, physicians and dentists sometimes treat each symptom individually and do not recognize that a systemic disease is present. The average time from the onset of symptoms to diagnosis is 2.8 years.

What kind of doctor treats Sjögren’s?

Rheumatologists have primary responsibility for managing Sjögren’s. Patients are also seen and treated by specialists such as ophthalmologists, optometrists, dentists and other specialists as necessary to treat their various  complications.

How is Sjögren’s diagnosed?

Unfortunately, there is no single test that will confirm the diagnosis of Sjögren’s and thus physicians must conduct a series of tests and ask about symptoms the patient is experiencing. Physicians will use a number of tests to determine a Sjögren’s diagnosis.

Objective tests used in diagnosis include:

Blood tests you may have include:
• SS-A (or Ro) and SS-B (or La): Marker antibodies for Sjögren’s. 70% of Sjögren’s patients are positive for SS-A and 40% are positive for SS-B.
Also found in lupus patients.

Eye tests most commonly used include:
• Schirmer test: Measures tear production.
• Rose Bengal and Lissamine Green: Use of dyes to examine the surface of the eye for dry spots.

Dental tests most commonly used include:
• Salivary flow: Measures the amount of saliva produced over a certain period of time.
• Salivary gland biopsy (usually in the lower lip): Confirms lymphocytic infiltration of the minor salivary glands.

Bonus: Anti-Inflammatory Diet Suggestions

Inflammation is a component of Sjögren’s and essentially all autoimmune disease. From a
naturopathic perspective of treating the cause of disease, one of the first ways to address this is through an Anti-Inflammatory Diet. This upstream approach to treatment focuses on avoiding proinflammatory foods and eating a diet rich in anti-inflammatory foods. Additionally, since medical research is converging on inflammation as the common link in most diseases (i.e., heart disease, Alzheimer’s, asthma, diabetes, cancer, etc.), eating an anti- inflammatory diet is a great model of dietary health for everyone.

Avoid most packaged foods with a long list of ingredients. When preparing foods select raw, fresh, steamed, or broiled options over fried, Barbequed, or highly-processed choices.

Specific recommendations are:

Eat More
    • Colorful Whole Fruits and Vegetables – Eating foods with deep red, yellow, orange, and green colors provide vitamins and minerals, phytonutrients, fiber and potent antioxidants that minimize inflammation. Eating foods as close to their unrefined state preserves the content of these beneficial nutrients.
    • Healthy Fats – This includes the omega 3 oils found in fatty fish (salmon, mackerel,
      sardines) and foods such as avocados, extra virgin olive oil, raw nuts and seeds.
    • Fiber – Fiber promotes adequate bowel movements, creates a favorable environment for healthy bacteria in your gut, and supports the body’s overall detoxification process. A few tablespoons of ground flax seeds daily are a great way to add soluble and insoluble fiber.
    • Moderate Amounts of Organic Meat – Grass-fed beef or bison is higher in anti-inflammatory essential fats. Organic free-range chicken tends to be lower in antibiotics and are fed a vegetable/grain-based diet which tends to offer cleaner sources of protein.
    • Spices/Herbs – Seasonings such as garlic, ginger, and turmeric add an anti-inflammatory component to the diet.
Eliminate / Eat Less
    • Trans or Hydrogenated Fats – The body has no mechanism to use these unnatural fats that ultimately cause inflammation. These should be eliminated from your diet.
    • Refined Oils – Commercial safflower, corn, and canola oils have had much of their health promoting content removed for shelf-storage purposes and tend to be high in omega 6 fats that can be converted to inflammatory arachidonic acid, a type of fat that stimulates inflammation in the body.
    • High Glycemic or Processed Foods – Highly processed carbohydrates such as breads, pastas, cakes, candy, fruit juice, and corn syrup are quickly digested leading to a rapid rise in blood sugar and a subsequent inflammatory cascade stimulated by insulin.
    • Red Meat – Avoid these meats when possible or eat organic grass-fed meat to reduce
      ingesting high levels of pro-inflammatory arachidonic acid.
    • Common Food Allergies – Milk products, eggs, gluten from wheat, and peanuts can cause inflammatory reactions in many people and are best avoided.
    • Artificial Sweeteners & Preservatives – These additives have no nutritional value and tend to promote inflammatory reactions.