Materiały źródłowe

• #1 Sjogren’s syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221

  Treatment for Sjogren’s syndrome depends on the parts of the body affected. Many people manage the dry eye and dry mouth of Sjogren’s syndrome by using over-the-counter eyedrops and sipping water more frequently. But some people need prescription medications, or even surgical procedures. […] Depending on your symptoms, your doctor might suggest medications that: […] A minor procedure to seal the tear ducts that drain tears from your eyes (punctal occlusion) might help relieve your dry eyes. Collagen or silicone plugs are inserted into the ducts to help preserve your tears. […] Many Sjogren’s syndrome symptoms respond well to self-care measures. […] To relieve dry eyes: […] To help with dry mouth: […] Dry mouth increases your risk of dental cavities and tooth loss. To help prevent those types of problems: […] If dry skin is a problem, avoid hot water when you bathe and shower. Pat your skin don’t rub with a towel, and apply moisturizer when your skin is still damp. Use rubber gloves when doing dishes or housecleaning. Vaginal moisturizers and lubricants help women who have vaginal dryness.

• #1 Diagnosis and Management of Sjögren Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0315/p465.html

  Patient information: See related handout on Sjgren syndrome, written by the authors of this article. […] Sjgren syndrome is a challenging diagnosis, requiring the family physician to coordinate with a team of specialists, including dentists, otolaryngologists, rheumatologists, and ophthalmologists. Pilocarpine and cevimeline can help relieve dry eyes and dry mouth. […] The muscarinic agonists pilocarpine (Salagen) and cevimeline (Evoxac) can be used to relieve xerophthalmia in patients with Sjgren syndrome. Muscarinic agonists improve subjective and objective signs and symptoms of xerostomia in patients with Sjgren syndrome. […] Treatment focuses on relieving symptoms and preventing complications. Treatments can be grouped into regimens for KCS, xerostomia, and systemic manifestations.

• #1 Sjogren’s Disease | The University of Kansas Health System

  https://www.kansashealthsystem.com/care/conditions/sjogrens-disease

  The University of Kansas Health System is proud to have 1 of only a handful of specialized programs in the U.S. dedicated to care and research for Sjogren’s disease. […] This disease is approached by the collaboration of different providers of several specialties. Patients are frequently seen by rheumatologists, ophthalmologists, otolaryngologists (ear, nose and throat), pulmonologists, neurologists and other providers.

• #1 The Importance of Dry Mouth Care in Patients with Sjögren’s Syndrome and Current Approaches [J Educ Res Nurs]

  https://jer-nursing.org/jvi.aspx?un=JERN-55890&volume=19&issue=2

  Nurses make valuable contributions in standardizing the symptoms of patients, managing the care interventions to be applied, training to be given to the patients, and preventing their repeated admissions to the health institutions. […] The aim of this review is to examine the importance of oral care, current approaches, and nursing interventions in patients diagnosed with Sjgrens syndrome.

• #1 The Importance of Dry Mouth Care in Patients with Sjögren’s Syndrome and Current Approaches [J Educ Res Nurs]

  https://jer-nursing.org/jvi.aspx?un=JERN-55890&volume=19&issue=2

  Sjgrens syndrome is a significant health problem and the second most common autoimmune rheumatic disease, which can cause common systemic symptoms and negatively affect patients quality of life and survival. […] The main symptoms of Sjgrens syndrome include dry mouth and eyes. […] It is recommended to evaluate salivary gland function before starting treatment for dry mouth. […] It is very important to enquire about the drugs used by the patient; to obtain a comprehensive medical history, including physical examination; to perform special function tests; and to evaluate the symptoms. […] It is recommended to use topical fluoride and fluoride remineralizing agents in patients with Sjgrens syndrome and dry mouth. […] The responsibilities of nurses include making evaluations, providing oral care, preventing symptoms that may develop in the mouth, providing support to patients when necessary, and training patients.

• #1 Sjogren’s Syndrome – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/sjogrens-syndrome/

  Impaired skin integrity related to diminished or absent glandular secretions […] Care of the patient with SS is designed to treat symptoms. Instill artificial tears as often as every 30 minutes to prevent corneal ulcerations or opacifications that may be caused by insufficient lacrimal secretions. […] Inspect oral mucosa for oral Candida infection, ulcers, saliva pools, and dental hygiene. […] Instruct or assist patient in proper oral hygiene. […] Encourage frequent intake of non-caffeinated, non-sugar liquids. Keep pitcher filled with cool water. […] Instruct or assist patient in daily inspection of skin for areas of trauma or potential breakdown. […] Apply lubricants to skin daily. […] Avoid shearing forces and encourage or perform frequent position changes. […] Increase liquid intake with meals.

• #1 Sjögren’s Disease: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/sjogrens-disease/diagnosis-treatment-and-steps-to-take

  There is no cure for Sjgrens disease, so treatment focuses on relieving symptoms and preventing complications. Treatments are different for each person and will depend on which parts of the body are affected. Your treatment plan will likely include a combination of self-management approaches and over-the-counter and prescription medications. Be sure to tell your doctor which medications you are currently taking because some make eye and mouth dryness worse. […] […] Caring for your eyes. Protect your eyes from drafts, breezes, and smoky rooms. Have your glasses fitted with shields on the sides, or use wraparound glasses. Do not use eye drops that irritate your eyes. If one brand or prescription bothers you, try another. Eye drops that do not contain preservatives are usually essential if you use them four or more times per day on a regular basis. Put humidifiers in the rooms where you spend the most time, including the bedroom, or install a humidifier in the heating and air conditioning unit of your home. If you get blepharitis (eyelid inflammation), use warm compresses on your eyes to alleviate the discomfort. You may also gently wash the eyelids with a dilute solution of a mild detergent such as baby shampoo. […]

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  If you wear dentures and have had a fungal infection, be sure to disinfect them overnight to prevent the fungus from coming back. Your dentist can prescribe a nystatin suspension for this purpose. […] Dry nose — It is important to treat dry nose or stuffiness because blocked nasal passages can increase mouth breathing and can worsen dry mouth. Saline nasal sprays are available in most drugstores. […] Other causes of nasal blockage, including allergy or sinus infection, should be treated promptly. […] Blepharitis (eyelid inflammation) — Eyelid inflammation, also called blepharitis, causes symptoms that are similar to those of dry eye (swollen lids and redness of the inside of the lids). Gently washing the skin of the eyelids can relieve blepharitis. You can do this with a warm, wet washcloth and a small amount of „no tears” shampoo or non-soap face cleanser. With the eyes closed, the excess debris should be rubbed from the inner eye outward to the outer eye area.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  SJÖGREN’S DISEASE TREATMENT […] Treatment of Sjögren’s disease can be divided into three basic areas: […] Treatment of dry eyes and mouth. […] Treatment of problems such as oral yeast infections, eyelid irritation (blepharitis), and acid reflux. These problems can complicate Sjögren’s disease and can make the condition less responsive to other therapies. […] Treatment of fatigue and/or vague symptoms of poor concentration and of impaired memory (such as fibromyalgia). […] Treatment of dry eyes and dry mouth — Most people use artificial tears (eye drops) to treat dry eyes. Many different solutions are available; a clinician can recommend an appropriate choice based upon your pattern of dryness and fluid production in the eye. […] Some people are sensitive to the preservatives found in artificial tears. If you notice a burning or itching feeling, you can try a brand with a non-irritating preservative. Alternatively, there are preservative-free versions of moisturizing eye drops. These should be used if you instill the drops in your eyes four or more times a day. They come in small, single-dose containers that may be hard to open for some people who have joint and/or vision problems. Prescription eye drops containing the medications cyclosporine or lifitegrast, which suppress part of the local immune reaction, are also available. Some people with severe eye dryness require use of a tear made from their own serum. Scleral lenses, a contact lens that vaults over the cornea and rests on the whites of your eyes, can also be helpful for those with severe dry eye. A space between the cornea and the back of the scleral lens acts as a reservoir for artificial tear fluid to bathe the cornea continuously.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Stimulating saliva — Simply sucking on sugar-free candy or lozenges or chewing sugar-free gum can stimulate the flow of saliva. Products that contain xylitol can help reduce the risk for dental decay. In some people who do not respond adequately to such measures, medications (eg, pilocarpine or cevimeline) can be given to increase saliva production. […] Replacing secretions in the mouth — Sipping on water throughout the day is an easy and effective treatment of dry mouth for many people. The water does not have to be swallowed. It can be rinsed around the mouth and then spit out. […] If this does not help, an artificial saliva product (spray or lozenge) may be helpful. If you have painful gums, a gel that relieves dry mouth can be helpful. […] Preventing cavities — People with Sjögren’s disease are at increased risk for dental cavities. You should brush and floss after eating meals and snacks. An electric toothbrush is preferred. It is important for you to visit your dentist at least every six months for a cleaning and evaluation.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Some women with Sjögren’s disease have difficulty with vaginal dryness, especially after menopause. There are several products specifically designed for vaginal dryness, including vaginal moisturizers, estrogen cream, vitamin E oil, hyaluronic acid suppositories, and vaginal lubricants. Adequate artificial lubrication applied to BOTH partners can prevent painful intercourse. […] Treating other Sjögren’s-related problems […] Fungal infections in the mouth — Prescription medications are available to treat painful mouth lesions due to oral candidiasis (yeast infection, also called thrush). These are taken as either a daily pill or as a topical treatment, in the form of a troche (which is allowed to dissolve in the mouth) or a solution (which is swished around in the mouth before swallowing).

• #1 EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies | Annals of the Rheumatic Diseases

  https://ard.bmj.com/content/79/1/3

  Treatment of systemic disease should be tailored to organ-specific severity using the ESSDAI definitions. […] GCs should be used at the minimum dose and length of time necessary to control active systemic disease. […] Synthetic immunosuppressive agents should mainly be used as GC-sparing agents, with no evidence supporting the choice of one agent over another. […] B-cell targeted therapies may be considered in patients with severe, refractory systemic disease. […] The systemic organ-specific therapeutic approach may, as a general rule, follow the sequential (or combined) use of GCs, immunosuppressive agents and biologics.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Reflux (heartburn) — Acid reflux is more common in people with Sjögren’s disease. This is probably due to the decreased production of saliva, which normally helps to reduce the acidity of stomach acid. Treatment of reflux in people with Sjögren’s disease is similar to treatment in other people. […] Joint and muscle pain — Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen are recommended for the joint pain that may accompany Sjögren’s disease. […] Low-dose glucocorticoids (also called steroids) such as prednisone may also improve joint pain but are generally recommended for short-term treatment. Serious side effects may occur with long-term use (eg, weight gain, high blood pressure, diabetes, bone thinning). […] A class of medications called disease-modifying antirheumatic drugs (DMARDs) is commonly used in people with lupus and rheumatoid arthritis to slow the immune system’s destructive effects. Similar treatments have been used in patients with Sjögren’s disease. The most common is hydroxychloroquine, an antimalarial drug, which is widely used in the treatment of lupus and rheumatoid arthritis.

• #1 Survival Tips | Sjögren’s Foundation

  https://sjogrens.org/living-with-sjogrens/survival-tips

  Look below for short but essential survival tips for Sjgrens patients. […] It is important to find a doctor who is both a good partner in treating your disease, as well as a good listener! Never feel guilty about seeking a second opinion, especially given the overlap and uncertainty with Sjgrens. […] If you have Sjgrens and are employed, ask for needed accommodations such as flexible hours, additional breaks, or changes in your job duties. […] Join a Sjgrens Foundation Support Group to meet other people with Sjogrens. You will feel better knowing that you are not alone, you will learn more about Sjgrens from fellow patients and expert speakers, plus you will find new ways to cope with your disease. […] Find a doctor who will coordinate all of your care in Sjgrens and head your medical care team. Usually this is a rheumatologist, but a family doctor or general practitioner may also fill this role.

• #1 Sjogren’s Syndrome – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/sjogrens-syndrome/

  Assist or instruct patient to avoid choosing spicy or dry foods from menu choices. […] Suggest smaller, more frequent meals. […] Weigh patients weekly and review diet history for basic nutrient deficiencies. […] Advise patient on proper use of water-soluble vaginal lubrication. […] Suggest alternate positioning and practices to prevent dyspareunia. […] Teach the patient to recognize and report symptoms of vaginitis because infection may result from altered mucosal barrier. […] Advise patient of commercially available artificial saliva preparations, artificial tears, moisturizing nasal spray, and artificial vaginal moisturizers. […] Encourage frequent dental visits. Dental cavities are more frequent in patients with Sjogrens syndrome. […] Advice patient to check with health care provider before using any medications because many cause mouth dryness (eg, diuretics, tricyclic antidepressants, antihistamines). […] Advice patient to wear protective eyewear while outdoors.

• #1 Sjogren’s Syndrome: 9 Natural Ways to Manage Self Care – Dr. Axe

  https://draxe.com/health/sjogrens-syndrome/

  Sjogrens syndrome is one of the most prevalent autoimmune diseases in the United States, affecting an estimated 7,000,000 people, with only 4,000,000 of those being diagnosed. […] While there is no cure, Sjogrens syndrome can go into remission, or symptoms may come and go. […] While generally not considered a fatal disease, it is a serious one, and it is crucial that patients be monitored for potential complications. […] Special precautions and regular communication with a rheumatologist is recommended so that any complication is caught quickly. […] This condition is not curable, but effective treatments to help minimize Sjogrens syndrome symptoms are available. […] Like most autoimmune diseases, there is no cure. Conventional treatment protocols work to alleviate symptoms and prevent the development of potentially serious complications.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Fatigue — Fatigue is common in Sjögren’s disease. Fatigue may be due to the active inflammation associated with the disease itself, fibromyalgia, and/or sleep disturbances. Sleep problems can result if you drink a lot of water to treat dry mouth and then need to get up frequently at night to urinate. […] General treatment for fatigue includes the attention to diet and exercise that has been helpful in people with fibromyalgia. In addition, in people with Sjögren’s disease, it is important to adequately control symptoms of dry mouth and dry eye that interfere with sleep. […] Fibromyalgia — Some people with Sjögren’s disease also have a condition called fibromyalgia. Fibromyalgia causes muscle aching and fatigue. The treatment of fibromyalgia is discussed separately. […] Vasculitis — Vasculitis is inflammation of blood vessels. Damage to arteries or veins may result in bleeding, pain, and damage to skin, nerves, and internal organs. When vasculitis occurs, it often requires treatment with drugs that suppress the immune system. Medications such as rituximab, cyclophosphamide, azathioprine, or mycophenolate mofetil may be prescribed by clinicians experienced in their use. Careful monitoring for side effects and for response to treatment is necessary.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8835

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. […] Use artificial tears during the day. If one brand doesn’t work, try another. Try to use preservative-free drops. They may be easier on your eyes. […] Drink fluids during the day to keep your mouth moist. Try drinking small sips of water and rinsing your mouth a lot. […] Take anti-inflammatory medicines if you have joint pain and swelling. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Read and follow all instructions on the label. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if your eyes and mouth are still very dry even with home care.

• #1 Sjogren’s Syndrome: 9 Natural Ways to Manage Self Care – Dr. Axe

  https://draxe.com/health/sjogrens-syndrome/

  For immune system health, and to increase both tear and saliva production, take 1,000 milligrams of vitamin C daily, in addition to including vitamin C-rich foods in your diet. […] While a relatively small percentage of patients develop lymphoma, it is imperative that any abnormal swelling in the glands around the face, neck, under the arms or in the groin area are evaluated immediately by your rheumatologist.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Anesthesia and Sjögren’s disease — If you need surgery, the anesthesiologist should be made aware of your diagnosis of Sjögren’s disease. This is because Sjögren’s disease can increase the risks of general anesthesia. There may be an increased risk of developing mucous plugs in the airways during and after surgery, and medications used during the surgery can dry the airways further. If aware of the diagnosis of Sjögren’s disease, the anesthesiologist can take special measures to lower the risk of these complications. […] Pregnancy — Pregnancy outcomes in women with Sjögren’s disease are generally similar to those of healthy women. However, women with Sjögren’s disease who have anti-Ro/SSA antibodies have a small risk of giving birth to a baby with a condition called „neonatal lupus,” which sometimes includes the baby being born with a potentially serious heart problem called congenital heart block.

• #1 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Neonatal lupus with congenital heart block occurs in about 2 to 4 percent of newborns of mother with Sjögren’s disease who have these antibodies. Other features of neonatal lupus, including skin rashes (which are seen more often than the heart block), abnormal blood counts, and liver abnormalities, are all usually temporary, unlike the heart block. It is important to detect the heart block early, which can be done by monitoring during pregnancy. Thus, women with these antibodies who become pregnant should be monitored by a maternal-fetal medicine specialist as part of their care during pregnancy. […] WHERE TO GET MORE INFORMATION […] Your health care provider is the best source of information for questions and concerns related to your medical problem. […] This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

• #1 Sjögren’s Disease: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/sjogrens-disease/diagnosis-treatment-and-steps-to-take

  Caring for your mouth. Brush and floss your teeth regularly. There are some kinds of toothpaste designed for people with dry mouths. Most people should use toothpaste with fluoride to help prevent cavities. Carry a water bottle and sip on it throughout the day to keep your mouth moist. Keeping hydrated will also help combat dry eyes. Chewing gum or sucking on hard candy helps your glands make more saliva. Try to use sugar-free gum and candy. Visit a dentist at least twice a year to have your teeth examined and cleaned. Ask your dentist about fluoride treatments. See your doctor or dentist if you have symptoms of candidiasis (also called thrush), such as burning, soreness, and white patches inside your mouth. […] […] Managing other Sjgrens disease-related symptoms. Moisturize other dry areas. For dry skin, moisturize your skin regularly, especially with products made for extra dry skin. Use lip balms, such as those containing petroleum jelly, for dry lips. Use products such as vaginal moisturizers or estrogen creams for vaginal dryness. Use saline sprays to help with dry nose. Educate yourself and get support. Learn as much as you can about the disease and talk with others who are dealing with it by joining a support group. Having a support network can help you manage difficult times. Having a long-term condition can be challenging, so visit a mental health professional if emotional problems arise. Maintain a healthy weight and watch what you eat to help control acid reflux. Eat slowly and avoid common triggers such as fried and fatty foods, tomato sauce, and onions. Eat a healthy and balanced diet, and exercise regularly to help combat fatigue and to help you sleep better. Check with your doctor before beginning an exercise routine. […] […] Remember to visit your health care providers regularly and to follow their recommendations.

• #1 Sjogren Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431049/

  In addition, the pharmacist should educate the patient on proper use of artificial tears and gels. […] The patient should also be referred to a physical therapist to regain joint function and build on muscle strength. […] Finally, the disorder can affect mood and a referral to a mental health counselor may be required.

• #1 Sjogren Syndrome: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/332125-overview

  Educate patients with Sjgren syndrome on avoidance strategies and self-care issues for the treatment of dry mouth, eyes, skin, and vagina. Patient education pamphlets regarding the disease are available through the Arthritis Foundation. The Sjgrens Syndrome Foundation, founded in 1983, is a good resource for patients.

• #2 Sjogren’s Syndrome – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/sjogrens-syndrome/

  Impaired skin integrity related to diminished or absent glandular secretions […] Care of the patient with SS is designed to treat symptoms. Instill artificial tears as often as every 30 minutes to prevent corneal ulcerations or opacifications that may be caused by insufficient lacrimal secretions. […] Inspect oral mucosa for oral Candida infection, ulcers, saliva pools, and dental hygiene. […] Instruct or assist patient in proper oral hygiene. […] Encourage frequent intake of non-caffeinated, non-sugar liquids. Keep pitcher filled with cool water. […] Instruct or assist patient in daily inspection of skin for areas of trauma or potential breakdown. […] Apply lubricants to skin daily. […] Avoid shearing forces and encourage or perform frequent position changes. […] Increase liquid intake with meals.

• #2 Sjögren’s Syndrome | IU Health

  https://iuhealth.org/find-medical-services/sjogrens-syndrome

  Sjögren’s syndrome, an inflammatory condition, causes a decrease in your body’s ability to produce saliva and tears. Although no cure exists for Sjögren’s syndrome, physicians at IU Health provide highly individualized treatment to control your symptoms, prevent complications and help you maintain a high quality of life. […] Physicians at IU Health also take advantage of their comprehensive referral network to connect you with ophthalmologists and other specialists for management of specific problems. With appropriate management of the condition, you can generally continue with your typical activities and enjoy a normal lifespan. […] IU Health physicians offer several types of treatment for Sjögren’s syndrome. Options include: Dry eye preparations. You can purchase artificial tears over-the-counter and in prescription form. Other ointments and topical anti-inflammatory agents can also help. Punctal occlusion. In this procedure, your physician blocks the tear ducts in order to keep your tears on your eye’s surface. Saliva substitutes. Physicians use these agents to reduce oral symptoms of Sjögren’s syndrome by mimicking some of the properties of saliva. Dry mouth medications. Physicians can prescribe certain drugs to stimulate the salivary glands. Non-steroidal anti-inflammatory drugs (NSAIDs). These medications available in over-the-counter and prescription versions can reduce your joint and muscle pain. Corticosteroids. Synthetic hormones such as prednisone may decrease inflammation that poses a risk to your lungs, kidneys, blood vessels or other body systems. Immune suppressants. These medications may help to prevent organ damage from Sjögren’s syndrome.

• #2 Sjogren’s Syndrome: Symptoms, Treatment, Causes, Test & Prognosis

  https://www.emedicinehealth.com/sjogren_syndrome/article_em.htm

  Sjogren’s syndrome treatment includes medications, diet, and surgery. […] For the most part, treatment is designed to help relieve symptoms. […] If you have Sjgren’s syndrome, several different professionals will probably be involved in your care. […] Your primary care provider should always be part of your team. […] Rheumatologists have the most specific training and experience in Sjgren’s syndrome as well as the many disorders often associated with the syndrome. […] Ophthalmologists can diagnose early problems with the cornea and assess the degree of damage to the eye. If necessary, they also can perform surgery to help treat or prevent eye damage. […] Otolaryngologists (ear, nose, and throat specialists) may be needed if a salivary gland biopsy is necessary to establish a diagnosis.

• #2 Sjogren Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431049/

  Primary Sjogren syndrome is a systemic autoimmune disorder commonly presenting with dryness involving the eyes and mouth due to inflammation and resultant pathology of the lacrimal and salivary glands. […] Sjogren syndrome is managed by replacing moisture at affected glandular sites and diminishing the autoimmune response locally as well as systemically. […] The management revolves around decreasing the morbidity of the symptoms. Besides physicians, both the pharmacist and nurse play a vital role in patient education. […] The patient should be educated on prevention of dental caries, using fluoride-containing toothpaste and using sugar-free chewing gums and lozenges to promote saliva production. […] For dry eyes, the pharmacists should educate the patient on changing the diet and eliminating medications that cause reduced secretions.

• #2 Sjögren’s Syndrome: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4929-sjogrens-syndrome

  Your provider will suggest treatments to manage your symptoms. Theres no cure for Sjgrens syndrome, but your provider will help you find a treatment plan that reduces its impact on your daily routine and quality of life. […] Some common treatments for dryness in your eyes, mouth or vagina include: […] Your eye care specialist might suggest over-the-counter (OTC) eye drops, prescription drops or lubricants to keep your eyes moist. […] Your dentist may suggest over-the-counter saliva (spit) supplements or prescriptions to help your body make more saliva. […] Your provider will suggest over-the-counter or prescription lubricants to add moisture to your vagina every day or during sexual intercourse. […] People with Sjgrens syndrome have a higher risk of dental health issues, so you may need more frequent cleanings, special fluoride treatments or prescription toothpaste and mouthwash. […] Talk to your provider about adjusting your treatments if you feel like your symptoms are changing, getting worse or affecting your daily routine more than they should.

• #2 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  At night, you can use an eye ointment to provide moisture. It is important to use only a small amount (about 1/8 inches or 3 mm) of the ointment, because overuse can block the ducts and can lead to a condition called blepharitis. […] Some people try taking omega-3 fatty acid supplements (eg, fish oil) to help with their dry eyes, although evidence is mixed and it is not clear whether this is effective. […] Preserving natural tears — There are various measures you can try to preserve your own tears. Shields can be fitted on the sides of glasses, helping to protect the eyes from air and wind and reducing evaporation of tears. Goggles or wraparound sunglasses serve a similar function. […] Another approach is a simple procedure called punctal occlusion. In this procedure, an ophthalmologist inserts tiny plugs into the tear ducts in the corner of the lower eyelid, nearest the nose, where the tears normally collect and drain into the nose. By blocking this duct, your tears stay on the eye longer. There are several types of plugs, one of which does not touch the surface of the eyeball; these plugs are generally preferred.

• #2 How to Improve Oral & Eye Health in Sjögren’s Patients – The Rheumatologist

  https://www.the-rheumatologist.org/article/how-to-improve-oral-eye-health-in-sjogrens-patients/

  Ophthalmologists who treat dry eye in Sjgrens syndrome patients take a stepwise approach depending on its severity. They educate patients, suggest the modification of environmental factors and addition of lubricants. […] Both ophthalmologists and rheumatologists may suggest artificial tears. If there is a strong need for artificial tears, the patient should use preservative-free ones, Dr. Akpek said. […] After these first steps, ophthalmologists may prescribe topical immunomodulators, such as lifitegrast and cyclosporine A.

• #2 Sjögren’s Disease: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/sjogrens-disease/diagnosis-treatment-and-steps-to-take

  Caring for your mouth. Brush and floss your teeth regularly. There are some kinds of toothpaste designed for people with dry mouths. Most people should use toothpaste with fluoride to help prevent cavities. Carry a water bottle and sip on it throughout the day to keep your mouth moist. Keeping hydrated will also help combat dry eyes. Chewing gum or sucking on hard candy helps your glands make more saliva. Try to use sugar-free gum and candy. Visit a dentist at least twice a year to have your teeth examined and cleaned. Ask your dentist about fluoride treatments. See your doctor or dentist if you have symptoms of candidiasis (also called thrush), such as burning, soreness, and white patches inside your mouth. […] […] Managing other Sjgrens disease-related symptoms. Moisturize other dry areas. For dry skin, moisturize your skin regularly, especially with products made for extra dry skin. Use lip balms, such as those containing petroleum jelly, for dry lips. Use products such as vaginal moisturizers or estrogen creams for vaginal dryness. Use saline sprays to help with dry nose. Educate yourself and get support. Learn as much as you can about the disease and talk with others who are dealing with it by joining a support group. Having a support network can help you manage difficult times. Having a long-term condition can be challenging, so visit a mental health professional if emotional problems arise. Maintain a healthy weight and watch what you eat to help control acid reflux. Eat slowly and avoid common triggers such as fried and fatty foods, tomato sauce, and onions. Eat a healthy and balanced diet, and exercise regularly to help combat fatigue and to help you sleep better. Check with your doctor before beginning an exercise routine. […] […] Remember to visit your health care providers regularly and to follow their recommendations.

• #2 Sjogren’s Syndrome – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/sjogrens-syndrome/

  Assist or instruct patient to avoid choosing spicy or dry foods from menu choices. […] Suggest smaller, more frequent meals. […] Weigh patients weekly and review diet history for basic nutrient deficiencies. […] Advise patient on proper use of water-soluble vaginal lubrication. […] Suggest alternate positioning and practices to prevent dyspareunia. […] Teach the patient to recognize and report symptoms of vaginitis because infection may result from altered mucosal barrier. […] Advise patient of commercially available artificial saliva preparations, artificial tears, moisturizing nasal spray, and artificial vaginal moisturizers. […] Encourage frequent dental visits. Dental cavities are more frequent in patients with Sjogrens syndrome. […] Advice patient to check with health care provider before using any medications because many cause mouth dryness (eg, diuretics, tricyclic antidepressants, antihistamines). […] Advice patient to wear protective eyewear while outdoors.

• #2 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  If you wear dentures and have had a fungal infection, be sure to disinfect them overnight to prevent the fungus from coming back. Your dentist can prescribe a nystatin suspension for this purpose. […] Dry nose — It is important to treat dry nose or stuffiness because blocked nasal passages can increase mouth breathing and can worsen dry mouth. Saline nasal sprays are available in most drugstores. […] Other causes of nasal blockage, including allergy or sinus infection, should be treated promptly. […] Blepharitis (eyelid inflammation) — Eyelid inflammation, also called blepharitis, causes symptoms that are similar to those of dry eye (swollen lids and redness of the inside of the lids). Gently washing the skin of the eyelids can relieve blepharitis. You can do this with a warm, wet washcloth and a small amount of „no tears” shampoo or non-soap face cleanser. With the eyes closed, the excess debris should be rubbed from the inner eye outward to the outer eye area.

• #2 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Toothpastes designed specifically for people with dry mouth are available. These lack the detergents that are present in many types of toothpaste but can irritate a dry mouth. Toothbrushes with special features that help clean between the teeth (including electric toothbrushes) may also help to keep your teeth clean. […] Toothpaste with fluoride (or a special fluoride rinse or varnish) may help to prevent cavities. A fluoride treatment after each dental cleaning may also be helpful. Other products that help preserve dental integrity include chewing gums that keep the pH neutral on the dental surface and toothpastes that bind calcium and phosphate ions to tooth surfaces. […] Dryness in other areas — People with Sjögren’s disease may have dryness in other areas, including the lips, the skin, and the vagina. For dry lips, you can use petroleum jelly or lip balms or salves. Dry skin usually improves with frequent and liberal use of a moisturizing cream or ointment. „Extra dry skin” lotion can be applied in the morning and at bedtime (and after baths or showers).

• #2 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Reflux (heartburn) — Acid reflux is more common in people with Sjögren’s disease. This is probably due to the decreased production of saliva, which normally helps to reduce the acidity of stomach acid. Treatment of reflux in people with Sjögren’s disease is similar to treatment in other people. […] Joint and muscle pain — Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen are recommended for the joint pain that may accompany Sjögren’s disease. […] Low-dose glucocorticoids (also called steroids) such as prednisone may also improve joint pain but are generally recommended for short-term treatment. Serious side effects may occur with long-term use (eg, weight gain, high blood pressure, diabetes, bone thinning). […] A class of medications called disease-modifying antirheumatic drugs (DMARDs) is commonly used in people with lupus and rheumatoid arthritis to slow the immune system’s destructive effects. Similar treatments have been used in patients with Sjögren’s disease. The most common is hydroxychloroquine, an antimalarial drug, which is widely used in the treatment of lupus and rheumatoid arthritis.

• #2 Sjogren’s Syndrome – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/sjogrens-syndrome/

  Abatacept, a T-cell-targeted therapy, has been demonstrated in several studies to increase saliva production and decrease systemic symptoms of the condition as well as glandular inflammation. […] Infliximab is a TNF- antagonist that is used to treat certain types of arthritis, bowel disease, and skin disease. Further research is needed to evaluate the efficacy of topical infliximab in patients with Sjgrens syndrome. […] Tocilizumab is an IL-6 receptor antagonist and has been linked to multiple autoimmune disorders. IL-6 levels are higher in the tears, saliva, and blood of patients with Sjgrens syndrome. Clinical trials of tocilizumab in this setting are ongoing. […] To minimize significant side effects such as elevated blood pressure, weight gain, hyperglycemia, and bone loss, systemic corticosteroids should only be administered for a limited period of time. Patients with primary Sjogrens syndrome undergoing treatment with methotrexate should receive folic acid supplementation to reduce gastrointestinal side effects.

• #2 Survival Tips | Sjögren’s Foundation

  https://sjogrens.org/living-with-sjogrens/survival-tips

  You can maintain a good quality of life with Sjgrens. Stay on top of the latest information, educate yourself through the Sjgrens Foundation, find support and watch your limits. […] Remember that just because a symptom cant be seen easily, your symptom is still important. If you feel your Sjgrens symptoms are dismissed by a physician, help educate your physician and/or find another physician. […] Living a healthy lifestyle consisting of an anti-inflammatory diet, adequate sleep, exercise, and minimal stress are an important part of living well with a chronic disease like Sjgrens. […] Exercise is key to battling fatigue. It may seem counterproductive, but exercise will overcome fatigue, maintain flexibility and overcome joint and muscle pain. Consider adding yoga to your routine. […] Relaxation and Meditation techniques may be a good practice that can help alleviate stress and anxieties that may lead to sleep disturbances. […] Sjgrens patients who have trouble sleeping should make sure the bedroom is comfortable, secure, dark, cool, quiet and well-humidified. Avoid T.V. and screen time in bed or just before bedtime. […] Use nasal sprays and gels to moisturize and clean your nose and prevent getting stuffed up.

• #2 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Anesthesia and Sjögren’s disease — If you need surgery, the anesthesiologist should be made aware of your diagnosis of Sjögren’s disease. This is because Sjögren’s disease can increase the risks of general anesthesia. There may be an increased risk of developing mucous plugs in the airways during and after surgery, and medications used during the surgery can dry the airways further. If aware of the diagnosis of Sjögren’s disease, the anesthesiologist can take special measures to lower the risk of these complications. […] Pregnancy — Pregnancy outcomes in women with Sjögren’s disease are generally similar to those of healthy women. However, women with Sjögren’s disease who have anti-Ro/SSA antibodies have a small risk of giving birth to a baby with a condition called „neonatal lupus,” which sometimes includes the baby being born with a potentially serious heart problem called congenital heart block.

• #2 Support for Sjogren’s Syndrome | NYU Langone Health

  https://nyulangone.org/conditions/sjogrens-syndrome/support

  People with Sjogrens syndrome are at an increased risk for developing lymphoma, a cancer that affects the lymph nodes. […] If you are pregnant or trying to get pregnant and have Sjogrens syndrome, your rheumatologist may recommend that you consult a maternalfetal medicine doctor, a specialist in high-risk pregnancies and births. […] NYU Langone is recognized as one of the worlds premier research centers for autoimmune diseases in pregnancy and a leader in treating infants with heart block associated with autoimmunity.

• #2 Sjogren’s Syndrome: Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/sjogrens-syndrome

  Other treatments address some of the less common symptoms of Sjogren’s. For instance, if you get heartburn or acid reflux, your doctor may give you medicines that curb the amount of acid in your stomach. […] You might take over-the-counter or prescription pain relief drugs to ease joint or muscle pain. […] There are a lot of steps you can take on your own to help manage your symptoms. […] Sip water frequently. […] Chew gum or suck on candy to stimulate saliva flow and help keep your mouth moist. Be sure they’re sugar-free so you don’t get cavities. […] Brush and floss twice a day to avoid cavities. […] Apply moisturizer every day. […] Like any chronic condition, Sjogren’s can take a toll on your emotional health and your body. To best manage: Educate yourself. […] Join a support group. […] Take steps to care for your mental health. […] Request accommodations.

• #2 Sjögren’s Syndrome Program

  https://www.massgeneral.org/medicine/rheumatology/treatments-and-services/sjogrens-syndrome

  Sjgren’s syndrome is a chronic systemic (whole-body) autoimmune disease that predominantly affects the moisture-producing glands. The most common symptoms are dry eyes and dry mouth. […] In order to slow the progression and minimize the clinical impact of Sjgren’s syndrome, our rheumatologists work closely with specialists throughout Mass General, including ophthalmologists, oral surgeons, neurologists and nephrologists. […] Although there is no cure for Sjgren’s syndrome, early intervention and expert management may help prevent debilitating complications. Your treatment plan will include medications designed to address the various symptoms that you might experience throughout your body. […] Your rheumatologist will educate you about caring for your eyes, mouth and other areas affected by Sjgren’s syndrome. We will also schedule annual appointments at Mass General to monitor symptoms and disease progression and adjust your medications accordingly. […] There currently is no cure for Sjgren’s syndrome. However, treatments to manage symptoms can be highly effective in conjunction with educating patients on optimizing quality of life.

• #3 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  SJÖGREN’S DISEASE TREATMENT […] Treatment of Sjögren’s disease can be divided into three basic areas: […] Treatment of dry eyes and mouth. […] Treatment of problems such as oral yeast infections, eyelid irritation (blepharitis), and acid reflux. These problems can complicate Sjögren’s disease and can make the condition less responsive to other therapies. […] Treatment of fatigue and/or vague symptoms of poor concentration and of impaired memory (such as fibromyalgia). […] Treatment of dry eyes and dry mouth — Most people use artificial tears (eye drops) to treat dry eyes. Many different solutions are available; a clinician can recommend an appropriate choice based upon your pattern of dryness and fluid production in the eye. […] Some people are sensitive to the preservatives found in artificial tears. If you notice a burning or itching feeling, you can try a brand with a non-irritating preservative. Alternatively, there are preservative-free versions of moisturizing eye drops. These should be used if you instill the drops in your eyes four or more times a day. They come in small, single-dose containers that may be hard to open for some people who have joint and/or vision problems. Prescription eye drops containing the medications cyclosporine or lifitegrast, which suppress part of the local immune reaction, are also available. Some people with severe eye dryness require use of a tear made from their own serum. Scleral lenses, a contact lens that vaults over the cornea and rests on the whites of your eyes, can also be helpful for those with severe dry eye. A space between the cornea and the back of the scleral lens acts as a reservoir for artificial tear fluid to bathe the cornea continuously.

• #3 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Stimulating saliva — Simply sucking on sugar-free candy or lozenges or chewing sugar-free gum can stimulate the flow of saliva. Products that contain xylitol can help reduce the risk for dental decay. In some people who do not respond adequately to such measures, medications (eg, pilocarpine or cevimeline) can be given to increase saliva production. […] Replacing secretions in the mouth — Sipping on water throughout the day is an easy and effective treatment of dry mouth for many people. The water does not have to be swallowed. It can be rinsed around the mouth and then spit out. […] If this does not help, an artificial saliva product (spray or lozenge) may be helpful. If you have painful gums, a gel that relieves dry mouth can be helpful. […] Preventing cavities — People with Sjögren’s disease are at increased risk for dental cavities. You should brush and floss after eating meals and snacks. An electric toothbrush is preferred. It is important for you to visit your dentist at least every six months for a cleaning and evaluation.

• #3 Experts share best practices and recent insights to improve care for Sjögren’s syndrome – ACR Convergence Today

  https://www.acrconvergencetoday.org/experts-share-best-practices-and-recent-insights-to-improve-care-for-sjogrens-syndrome/

  Sara McCoy, MD, PhD, RhMSUS, Associate Professor of Rheumatology, University of Wisconsin, reviewed several pulmonary and renal case studies of Sjögren’s patients. Pulmonary screenings at baseline with pulmonary function tests and chest X-rays, even in asymptomatic patients, are suggested, she explained. Screenings for renal diseases, such as distal renal tubular acidosis, are also recommended. Metabolic acidosis might have implications for long-term health and should be treated. Glomerulonephritis is also a concern. […] Leslie Laing, PhD, BSc, BEd, MSc, DDS, FRCD(C), FAP, President, Sjögren’s Society of Canada, and Faculty of Dentistry, University of Toronto, Canada, shared best practices to treat hydrostomia, or dry mouth, a common symptom among Sjögren’s patients. Her therapeutic suggestions included regularly massaging oral glands, using herbal lollipops, and performing oil pulls with virgin coconut oil.

• #3 Sjogren’s syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sjogrens-syndrome

  There are many things you can do to manage your Sjogren’s syndrome including: Avoid dry and dusty environments, Avoid air drafts or windy weather, Wear protective glasses when outside in the wind and sun, Sip water regularly or suck ice cubes, Avoid strong soaps that may dry out your skin, Try to increase the humidity in your home, Exercise regularly, eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing, Eat soft, moist foods if you have trouble swallowing, Eat smaller, more frequent meals to stimulate saliva flow, Use warm (not hot) water when taking a shower or bath, Chew sugarless gum to stimulate saliva, Avoid salty, acidic or spicy foods and carbonated drinks that may be painful if your mouth is dry, Practice good dental hygiene and visit your dentist often.

• #3 Sjogren’s Syndrome – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/sjogrens-syndrome/

  The lack of sufficient saliva promotes development of dental caries in Sjogrens syndrome, making it critical for patients to maintain appropriate oral hygiene. To promote residual salivary flow, sugar-free sweets and chewing gums can be used. Sprays and gels containing artificial saliva are also available. […] Preservative-free artificial tear drops and ointments can alleviate ocular symptoms. Sjogrens syndrome can be complicated by blepharitis, which is treated with eyelid hygiene. Punctal occlusion is a mechanical procedure to prevent tears from draining and retain natural moisture on the ocular surface. […] Vaginal symptoms can be treated with nonhormonal moisturizers. Postmenopausal women may benefit from local hormone replacement therapy. […] Psychological symptoms can be effectively treated with exercise and self-care measures.

• #3 Sjogren’s Syndrome – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/sjogrens-syndrome/

  Pilocarpine and cevimeline can relieve symptoms of oral and ocular dryness. Ocular inflammation can also be treated with topical corticosteroids or cyclosporine. […] The first-line treatment for musculoskeletal discomfort and mild inflammatory arthritis associated with Sjgrens syndrome is hydroxychloroquine. There is some weak evidence that it reduces fatigue. […] If hydroxychloroquine fails to work, methotrexate given either alone or in combination with hydroxychloroquine should be used. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat general Sjogrens syndrome symptoms, including muscular pain and joint discomfort. […] Prednisone is used to treat Sjgrens syndrome because of its success in treating other autoimmune illnesses. Low-dose prednisone is used to treat arthritis in Sjgrens syndrome as well as cutaneous symptoms of the disease.

• #3 Sjogren’s Syndrome: Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/sjogrens-syndrome

  Other treatments address some of the less common symptoms of Sjogren’s. For instance, if you get heartburn or acid reflux, your doctor may give you medicines that curb the amount of acid in your stomach. […] You might take over-the-counter or prescription pain relief drugs to ease joint or muscle pain. […] There are a lot of steps you can take on your own to help manage your symptoms. […] Sip water frequently. […] Chew gum or suck on candy to stimulate saliva flow and help keep your mouth moist. Be sure they’re sugar-free so you don’t get cavities. […] Brush and floss twice a day to avoid cavities. […] Apply moisturizer every day. […] Like any chronic condition, Sjogren’s can take a toll on your emotional health and your body. To best manage: Educate yourself. […] Join a support group. […] Take steps to care for your mental health. […] Request accommodations.

• #3 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Neonatal lupus with congenital heart block occurs in about 2 to 4 percent of newborns of mother with Sjögren’s disease who have these antibodies. Other features of neonatal lupus, including skin rashes (which are seen more often than the heart block), abnormal blood counts, and liver abnormalities, are all usually temporary, unlike the heart block. It is important to detect the heart block early, which can be done by monitoring during pregnancy. Thus, women with these antibodies who become pregnant should be monitored by a maternal-fetal medicine specialist as part of their care during pregnancy. […] WHERE TO GET MORE INFORMATION […] Your health care provider is the best source of information for questions and concerns related to your medical problem. […] This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

• #3 Sjogren’s Syndrome: 9 Natural Ways to Manage Self Care – Dr. Axe

  https://draxe.com/health/sjogrens-syndrome/

  For immune system health, and to increase both tear and saliva production, take 1,000 milligrams of vitamin C daily, in addition to including vitamin C-rich foods in your diet. […] While a relatively small percentage of patients develop lymphoma, it is imperative that any abnormal swelling in the glands around the face, neck, under the arms or in the groin area are evaluated immediately by your rheumatologist.

• #3 Sjögren’s Syndrome | Durham, Raleigh, North Carolina | Duke Health

  https://www.dukehealth.org/treatments/inflammatory-and-immune-disorders/sjogrens-syndrome

  Specialized Care for Pregnant People with Sjgrens: A healthy pregnancy and baby are possible with Sjgrens Syndrome. However, the risk of complications is higher compared to people without the condition. We have a dedicated rheumatologist who sees women who are pregnant or wish to be pregnant and who have Sjgrens Syndrome.

• #3 Sjogren Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431049/

  Primary Sjogren syndrome is a systemic autoimmune disorder commonly presenting with dryness involving the eyes and mouth due to inflammation and resultant pathology of the lacrimal and salivary glands. […] Sjogren syndrome is managed by replacing moisture at affected glandular sites and diminishing the autoimmune response locally as well as systemically. […] The management revolves around decreasing the morbidity of the symptoms. Besides physicians, both the pharmacist and nurse play a vital role in patient education. […] The patient should be educated on prevention of dental caries, using fluoride-containing toothpaste and using sugar-free chewing gums and lozenges to promote saliva production. […] For dry eyes, the pharmacists should educate the patient on changing the diet and eliminating medications that cause reduced secretions.

• #4 Patient education: Sjögren’s disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/sjogrens-disease-beyond-the-basics

  Toothpastes designed specifically for people with dry mouth are available. These lack the detergents that are present in many types of toothpaste but can irritate a dry mouth. Toothbrushes with special features that help clean between the teeth (including electric toothbrushes) may also help to keep your teeth clean. […] Toothpaste with fluoride (or a special fluoride rinse or varnish) may help to prevent cavities. A fluoride treatment after each dental cleaning may also be helpful. Other products that help preserve dental integrity include chewing gums that keep the pH neutral on the dental surface and toothpastes that bind calcium and phosphate ions to tooth surfaces. […] Dryness in other areas — People with Sjögren’s disease may have dryness in other areas, including the lips, the skin, and the vagina. For dry lips, you can use petroleum jelly or lip balms or salves. Dry skin usually improves with frequent and liberal use of a moisturizing cream or ointment. „Extra dry skin” lotion can be applied in the morning and at bedtime (and after baths or showers).

• #4 Diagnosis and Management of Sjögren Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0315/p465.html

  Ocular treatment begins with topical tear replacement. If artificial tears do not satisfactorily relieve symptoms, the next step is increasing tear production by stimulating muscarinic receptors. […] Treatment for xerostomia consists of good oral hygiene, salivary stimulation, use of saliva substitutes, and recognition of complications. […] Daily topical fluoride use and antimicrobial mouth rinses can help prevent caries in patients with reduced salivary flow. […] Muscarinic agonists also may be used. An RCT of 44 patients showed that pilocarpine at a dosage of 5 mg four times daily is superior to placebo in improving subjective xerostomia. […] Another small RCT showed that cevimeline at a dosage of 30 mg three times daily improves xerostomia symptoms and salivary flow. […] Although pilocarpine and cevimeline have been shown to reduce symptomatic oral dryness and to produce transient increases in salivary flow, neither drug addresses the underlying disease process or leads to increases in basal nonstimulated salivary flow. […] Antimalarial medications and corticosteroids are being re-evaluated in the treatment of Sjgren syndrome.

• #4 Sjogren’s Syndrome – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/sjogrens-syndrome/

  For severe forms of visceral damage such as pulmonary, cutaneous, renal, neurological and musculoskeletal seen in Sjgrens syndrome, glucocorticoids or immunosuppressive therapy may be used. […] Increased use of biologic therapies in Sjgrens syndrome is based on an improved understanding of the mechanism of Sjgrens syndrome and the establishment of therapeutic targets for these agents in patients with other autoimmune disorders. […] Rituximab is a chimeric anti-CD20 monoclonal antibody that depletes B cells by causing a direct toxic effect on these cells over a period of 4 to 12 months. Rituximab treatment has been found to be effective for patients with primary Sjgrens syndrome. […] The monoclonal anti-BAFF antibody belimumab was shown to be effective in the treatment of Sjgrens syndrome in a prospective 1-year open-label bicentric study involving 30 patients.

• #4 Support for Sjogren’s Syndrome | NYU Langone Health

  https://nyulangone.org/conditions/sjogrens-syndrome/support

  People with Sjogrens syndrome are at an increased risk for developing lymphoma, a cancer that affects the lymph nodes. […] If you are pregnant or trying to get pregnant and have Sjogrens syndrome, your rheumatologist may recommend that you consult a maternalfetal medicine doctor, a specialist in high-risk pregnancies and births. […] NYU Langone is recognized as one of the worlds premier research centers for autoimmune diseases in pregnancy and a leader in treating infants with heart block associated with autoimmunity.

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