Sjögren’s syndrome is an autoimmune disorder that affects the moisture producing glands in the body. This includes the tear ducts and salivary glands. When Sjögren’s flares up, symptoms tend to worsen. Understanding what triggers these flare ups can help patients manage their condition.
What is Sjogren’s Syndrome?
Sjögren’s syndrome is an autoimmune disorder in which the body’s immune system mistakenly attacks its own healthy cells. In Sjögren’s, the attack targets the glands that produce moisture. This includes the tear glands and salivary glands.
As a result, the main symptoms of Sjögren’s syndrome include:
- Dry eyes
- Dry mouth
- Difficulty swallowing or speaking
- Hoarse voice
- Dry skin
- Vaginal dryness
- Joint pain
- Fatigue
Sjögren’s can occur alone as primary Sjögren’s syndrome. It may also develop alongside other autoimmune disorders like rheumatoid arthritis, lupus, or scleroderma as secondary Sjögren’s.
What is a Sjogren’s Flare Up?
The signs and symptoms of Sjögren’s may vary over time, often flaring up before settling back down. A flare up is when the symptoms suddenly get much worse for a period of time before improving again.
Potential flare up symptoms include:
- Greatly increased dryness in the eyes or mouth
- Difficulty swallowing
- Worsening joint pain
- Extreme fatigue
- Enlarged salivary glands
- Skin rashes
- Brain fog or confusion
- Numbness and tingling in the limbs
Flare ups may last days or even weeks. Identifying potential triggers can help patients anticipate and hopefully prevent flare ups or minimize their severity.
Common Sjogren’s Flare Up Triggers
Research into Sjögren’s syndrome has identified many possible triggers that may set off a flare up of symptoms:
Infections
Infections seem to be one of the most common triggers for Sjögren’s flares. Both bacterial and viral infections can cause the immune system to overreact, provoking inflammation that leads to worsening moisture deficiency and other Sjögren’s symptoms. This includes:
- Common colds and flu
- Gastroenteritis
- Sinus infections
- Bronchitis or pneumonia
- Urinary tract infections (UTIs)
- Strep throat
Any active infection should be treated promptly to try to minimize the risk and severity of a flare up.
Stress
High levels of mental or emotional stress may trigger Sjögren’s flares in some patients. Potential sources include:
- Work stress
- Family responsibilities
- Financial difficulties
- Grieving a loss
- Major life changes
- Relationship problems
Finding healthy ways to minimize and cope with stress can help stabilize Sjögren’s symptoms.
Hormonal Shifts
Shifts in hormones seem to affect Sjögren’s as well. Potential triggers include:
- Menstrual cycles
- Pregnancy
- Menopause
- Starting or stopping hormone medications like birth control or estrogen
Working with your doctor to maintain steady hormone levels may help prevent hormone-related flares.
Medications
Certain medications have drying side effects that can worsen Sjögren’s moisture deficiency. These include:
- Antihistamines
- Blood pressure medications
- Antidepressants
- Muscle relaxants
- Anti-seizure medications
Talk to your doctor about potential drying side effects when starting any new medication.
Weather Changes
Sjögren’s symptoms may flare along with shifts in the weather. This is most common when seasonal changes provoke drier conditions, like:
- Heat waves
- Very low humidity
- Arctic cold fronts
- Dry summer months
- Dry winter months with indoor heat on
Using humidifiers at home and work, drinking plenty of water, and moisturizing the eyes, mouth, and skin can help counteract seasonal dryness.
Poor Diet
An unbalanced diet low in nutrients could make Sjögren’s worse. Potential dietary triggers include:
- Not eating enough fruits and vegetables
- Consuming too much sugar and refined carbs
- Too much caffeine, alcohol, or spicy food
- Skipping meals
- Fasting
Eating a healthy, balanced diet focused on whole foods may help stabilize Sjögren’s. Staying hydrated is also key.
Extreme Fatigue
Since fatigue is a common symptom of Sjögren’s, an increase in exhaustion can sometimes trigger a flare up. Allowing time for proper rest and preventing fatigue may help stabilize symptoms.
Other Potential Sjogren’s Flare Triggers
In addition to the common triggers above, Sjögren’s flares may potentially be provoked by:
- Allergies or sensitivities to foods, chemicals, or other substances
- Skin products containing drying ingredients like alcohol or fragrances
- Smoking cigarettes or vaping
- Air travel
- Dry indoor air from heating or cooling systems
- Salivary gland biopsy
- Dental work
- Depression and anxiety
- Overexertion and fatigue
- Dehydration
Preventing and Managing Flare Ups
While Sjögren’s flares cannot always be prevented entirely, the following self-care tips may help reduce flare up frequency and intensity for some patients:
- Take medications as prescribed – Work with your doctor to find the right medications to manage dryness, joint pain, and other symptoms.
- Treat infections promptly – Seek medical care quickly for any possible infections before they trigger a flare.
- Reduce stress – Make time for relaxing activities and get support if you are dealing with major stressors.
- Use humidifiers – Keep the air humid at home and work during dry weather.
- Moisturize thoroughly – Use ointments for dry eyes and mouth, along with skin creams.
- Avoid irritants – Steer clear of cigarette smoke, heavily fragranced products, and other triggers.
- Exercise gently – Do light activity to reduce fatigue and joint pain.
- Drink plenty of fluids – Stay well hydrated by sipping water, broths, and caffeine-free drinks.
- Eat a balanced diet – Focus on lean proteins, fruits, vegetables, and whole grains.
- Get enough rest – Plan time to rest when fatigue increases.
Keeping a symptom journal can help you identify your personal flare triggers. This allows you to anticipate and try to prevent flares when those triggers are present.
If a flare does occur, additional medication like corticosteroids may be needed temporarily to reduce inflammation and manage symptoms.
When to See a Doctor
Contact your healthcare provider if you experience any of the following:
- A sudden worsening of dryness, pain, fatigue or other symptoms
- Difficulty swallowing, speaking, or opening your mouth
- Development of skin rashes or lesions
- High fever, nausea, or vomiting
- Sudden swelling in the face, feet, or abdomen
- Rapid weight gain or loss
- Numbness, tingling, or weakness
- Vision changes
- Chest pain or trouble breathing
Prompt medical care is crucial whenever new or worsening symptoms appear that may suggest a Sjögren’s flare or other medical issue.
The Outlook for Sjogren’s Flares
While Sjögren’s has no cure, paying close attention to potential flare triggers can help patients manage this chronic autoimmune disorder. Avoiding triggers whenever possible, staying hydrated, and using prescribed medications can reduce flare up frequency and severity.
Ongoing medical care is important as well to monitor for complications and adjust treatment as needed. With proper self-care and follow up, many patients find they can successfully control Sjögren’s flares and live full lives.
Conclusion
Sjögren’s syndrome is an autoimmune condition affecting the body’s moisture producing glands. Periodic flares lead to worsening dryness and other symptoms. Research suggests triggers ranging from infections and stress to weather changes, medications, and hormonal shifts may provoke flares. Managing these triggers along with following other self-care tips can help stabilize symptoms and improve quality of life. Ongoing medical treatment is also key for controlling Sjögren’s flare ups.