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INTRODUCTION — Sjögren's syndrome (SS) is
a multisystem disorder that presents with dryness of the mouth and
eyes and loss of taste. It is a autoimmune condition and fully
treatable. It can be seen with dry eyes, dry vagina, hearing
disorder to to dryness in the ear. Loss or alteration of taste.
GENERAL PRINCIPLES — Therapy can be grouped into at least three
separate aspects: a) topical therapy of dry eyes and dry mouth;
b)
treatment of systemic manifestations of SS and recognition of
therapies for other conditions that can exacerbate dryness
complaints; and
c) treatment of fatigue, vague cognitive, and pain
syndromes that resemble the poorly defined syndrome termed
"fibromyalgia." Therapy depends upon the severity of symptoms, which
may vary from none to severe, associated with secondary pathology
and, often, considerable morbidity.
Most patients with SS only require local treatment for sicca
symptoms.
Adequate explanation of the condition, including use of patient
information leaflets and information available on the internet, will
help in empowering patients to participate in their own care.
Avoidance of low humidity atmospheres such as air conditioned
stores, centrally heated houses, airplanes, windy locations, and
irritants such as dust and cigarette smoke.
A painful mouth is different than a dry mouth, as the former may
represent the development of oral candidiasis.
Irritated eyes that persist despite frequent use of tears may
represent a process such as blepharitis rather than simple aqueous
tear deficiency.
Good oral hygiene including tooth brushing and dental flossing
following meals and regularly scheduled dental prophylaxis with
application of topical fluorides.
Use of topical moisturizers and lozenges, and recognition that
sugar-free lozenges contain significantly less sugar than "low
sugar" mints.
Instruction about particular precautions at the time of surgery to
minimize the side effects of xerostomia/xerothalmia and prevent side
effects of medications that may have anti-cholinergic side effects.
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