You may be referred to a number of different specialists when you are diagnosed with Sjögren's syndrome depending on the parts of your body that it affects. Rheumatologists (joint specialists) are the main doctors who have specialist knowledge of Sjögren's syndrome. This is because of the association of Sjögren's syndrome with other diseases that affect the joints, such as rheumatoid arthritis and systemic lupus erythematosus. However, you may also be referred to a dentist, an eye specialist, a lung specialist or a kidney specialist. Your GP will continue to provide support for you and will usually prescribe your medication under the guidance of these other specialists..
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Treatment of dry eyes
•Avoid situations that make dry eye symptoms worse.These may include:?Low humidity and air conditioning.
?Wind.
?Dust and smoke (so, if appropriate, try to stop smoking if you are a smoker).
?Contact lenses.
?Prolonged reading or staring at a computer screen or television. This makes us blink less often so our eyes don't stay as moist.
•Glasses: special glasses can help to keep in moisture and reduce eye dryness.
•Artificial tears: these provide lubrication and come in the form of eye drops. Preservative-free eye drops help to reduce the risk of eye irritation. Paraffin eye ointments are helpful for use at night time as they are longer lasting. However, if used during the day, paraffin ointment may cause blurred vision.
•Tear duct treatment: if drops alone do not work, you may need some special treatment to the tear ducts in your eyes by an eye specialist. An instrument called a diathermy is used to close up the tear ducts.
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Treatment of dry mouth and related symptoms
•General measures that can help include:?Sip water throughout the day.
?Keep your teeth, gums and mouth as clean and healthy possible. Brush your teeth regularly, use dental floss and a mouth wash.
?Visit your dentist regularly.
?Using Vaseline® for dry, cracked lips.
?Chewing sugarless chewing gums.
•Artificial saliva: this can be used to keep the mouth moist and comes in the form of a spray, gel, liquid, lozenge or pastille.
•Saliva stimulants: in some people with Sjögren's syndrome, the saliva glands are only partially affected and can be stimulated to make more saliva. Pilocarpine tablets are saliva stimulants that are sometimes prescribed.
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Treatment of other symptoms
•Moisturisers and special bath additives can be used for dry skin.
•Lubricants may be needed when you have sex.
•Non-steroidal anti-inflammatory drugs (NSAIDs) can be taken to help joint and muscle pains.
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Treatment of complications
If Sjögren's syndrome progresses to involve organs such as the skin, lungs, kidneys and lymph glands, you may need to take some medication. Such medication may include:.
•Steroids: these are tablets taken by mouth that help to reduce inflammation. They may be prescribed if your symptoms are particularly bad.
•Immunosuppressive agents: these are drugs that damp down the abnormal antibody production in Sjögren's syndrome. Names include methotrexate, penicillamine and hydroxychloroquine. As with steroids, they are reserved for severe cases as they do have side-effects and you will need close monitoring with blood tests while you are taking them. For example, you may be prescribed one of these drugs if your kidneys or lungs are affected, or if you develop pseudolymphoma.
