Sjogren’s syndrome is an autoimmune disorder that affects the moisture-producing glands in the body. The most commonly affected glands are the tear glands and salivary glands, causing dry eyes and dry mouth. Sjogren’s syndrome can also affect moisture-producing glands in other parts of the body, leading to complications like dry skin, vaginal dryness, digestive issues, and joint pain.
A flare up refers to a sudden worsening of Sjogren’s syndrome symptoms. Sjogren’s flare ups can vary in severity and duration from person to person. Some of the most common symptoms experienced during a Sjogren’s flare include:
What causes a Sjogren’s flare up?
The exact triggers that cause Sjogren’s flares are not always clear, but some potential causes include:
- Infections – Respiratory infections, sinus infections, and viruses can trigger immune system activity that leads to a flare up.
- Stress – Physical or emotional stress may worsen Sjogren’s symptoms.
- Hormone changes – Fluctuations in female sex hormones during menstruation, pregnancy, and menopause can exacerbate symptoms.
- Medications – Some medications like antihistamines, diuretics, antidepressants, and painkillers may worsen dryness.
- Weather changes – Low humidity, windy conditions, and cold temperatures tend to dry mucous membranes.
- Diet – Spicy, acidic, or dry foods may irritate the mouth and digestive tract.
In many cases, the cause of a flare is unknown. Sjogren’s symptoms often fluctuate without any identifiable trigger. Working closely with your doctor to identify and avoid potential triggers can help reduce the frequency and severity of flares.
What are the symptoms of a Sjogren’s flare up?
Some of the most common symptoms experienced during a Sjogren’s flare include:
- Dry eyes – Gritty, irritated, burning, itchy eyes
- Dry mouth – Decreased saliva production, dry sticky mouth, cracked lips, mouth sores, sore throat, hoarse voice
- Fatigue – Lack of energy, exhaustion
- Joint pain – Stiffness, swelling, and pain in the joints
- Swollen salivary glands – Pain and swelling under the jaw, in cheeks, neck, or under the tongue
- Digestive issues – Heartburn, reflux, constipation, diarrhea
- Dry skin – Itchy, flaky, cracked skin
- Vaginal dryness – Painful intercourse, increased infections
- Dry nasal passages – Frequent nosebleeds, congestion, sinus infections
- Cognitive dysfunction – Impaired memory, concentration, and attention (“brain fog”)
The specific symptoms experienced during a flare vary from person to person. Keeping a symptom log can help identify your unique flare triggers and patterns.
How long does a Sjogren’s flare last?
The duration of Sjogren’s flares varies greatly, ranging from a few days to a few weeks or even months. Some people experience mild flares that come and go, while others have severe flares that cause debilitating symptoms.
In one study of Sjogren’s patients, researchers found:
| Flare Duration | Percentage of Patients |
|---|---|
| Less than 1 week | 19% |
| 1-2 weeks | 41% |
| 2-4 weeks | 25% |
| More than 1 month | 15% |
As shown, the majority of flares last between 1-4 weeks. However, each patient’s experience can vary.
If you are experiencing an unusually long or severe flare, be sure to follow up with your healthcare provider. You may need medication adjustments or further evaluation to identify factors prolonging the flare.
How is a Sjogren’s flare treated?
The main goals of treating a Sjogren’s flare are to alleviate symptoms and shorten the duration of the flare. Some approaches include:
Treating the underlying trigger
If an infection, medication, or other trigger initiated the flare, treating the underlying cause may help resolve symptoms faster. This may involve antibiotics for infections or adjusting medications under a doctor’s supervision.
Moisturizing agents
Increasing moisture in affected areas can provide symptom relief. This may include eye drops for dry eyes, saliva substitutes for dry mouth, vaginal moisturizers, and hydrating skin lotions. Humidifiers can also help moisturize dry airways.
Anti-inflammatory medications
Corticosteroids and other anti-inflammatory drugs can help reduce swelling, joint pain, and fatigue caused by inflammation during a flare.
Biologic medications
Medications that target specific parts of the immune system may be prescribed to treat severe or frequent Sjogren’s flares. Examples include Rituxan and Benlysta.
Lifestyle modifications
Getting adequate rest, staying hydrated, eating a balanced diet, and reducing stress can help cope with flares. Gentle exercise can help ease joint pain and fatigue without overexerting the body.
The right treatment approach depends on the severity of the flare and your specific symptoms. Work closely with your healthcare team to determine the most effective treatment options.
How can I prevent Sjogren’s flare ups?
While Sjogren’s flares cannot always be prevented entirely, the following self-care tips can reduce frequency and severity:
- Moisturize diligently – Use eye drops, gels, sprays, and ointments to keep affected areas lubricated.
- Stay hydrated – Drink plenty of fluids and opt for moisturizing foods.
- Use humidifiers – Keep air humid to prevent dryness.
- Avoid irritants – Cigarette smoke, scented products, and pollutants can exacerbate symptoms.
- Exercise gently – Low-impact activities like yoga, walking, and swimming can boost endorphins and promote joint health without taxing the body.
- Manage stress – Relaxation techniques, counseling, and support groups can help manage stress.
- Get sufficient rest – Fatigue can make flares worse.
- Take medications as prescribed – Work closely with your doctor regarding any needed medications or adjustments.
While you cannot always prevent flares completely, minimizing triggers, moisturizing diligently, and leading a healthy lifestyle can promote symptom stability and reduce flare frequency.
What emergency symptoms require immediate medical care during a Sjogren’s flare?
Seek prompt medical attention if you experience any of the following emergency symptoms during a Sjogren’s flare:
- Difficulty breathing – Shortness of breath can signal pneumonia or a lung complication.
- Heart palpitations – Irregular heartbeat may occur if Sjogren’s affects the heart.
- Fever over 102°F – High fever can indicate an infection requiring antibiotics.
- Sudden swelling in legs or abdomen – Fluid retention in the lower limbs or abdomen requires immediate treatment.
- Sudden change in mental status – Worsening confusion or concentration difficulties should be evaluated.
- Severe or bloody diarrhea – Can signal gastrointestinal complications of Sjogren’s.
- Vision loss – Blurry vision or vision loss warrants emergency care to treat possible retinal complications or vasculitis.
While most Sjogren’s flares can be managed at home, new or rapidly worsening symptoms require prompt medical intervention. Call your doctor right away or seek emergency care for dangerous symptoms.
What should I do to be prepared for a Sjogren’s flare up?
You can prepare for future Sjogren’s flares by:
- Having emergency numbers on hand – Save your rheumatologist’s office number and emergency contacts in your phone.
- Arranging help or backup care if needed – Make a plan for childcare or work responsibilities in case you become incapacitated.
- Having medications stocked – Keep extra supplies of your prescriptions and over-the-counter medications so you do not run out during a flare.
- Having moisturizing supplies – Stock up on lip balms, eye drops, nasal sprays, and anything else you find soothing.
- Having easy to prepare foods – Freeze some easy meals like soups, stews, or smoothies to eat when you do not have the energy for cooking.
- Canceling non-essential plans in advance – Do not commit to undertakings that will be difficult to manage during a flare.
- Arranging transportation if needed – Set up a plan for rides to doctor’s appointments if too fatigued to drive.
- Tracking your symptoms – Use a journal or app to identify flare triggers and patterns.
Being proactive and having a flare plan in place can help you cope with a flare if one occurs. Work with your healthcare providers to optimize your preparation and symptom management strategies.
Conclusion
Sjogren’s syndrome flare ups are characterized by a sudden worsening of dryness, pain, fatigue and other disease-related symptoms. While the exact cause of flares is not always known, potential triggers include infections, hormones, stress, weather changes, and medications.
Flare duration varies from days to weeks or months. Treatment focuses on managing symptoms and shortening flare length with moisturizers, anti-inflammatories, immune-modulating drugs, and lifestyle modifications.
While flares cannot always be prevented, self-care strategies like hydration, rest, and avoiding triggers can reduce frequency and intensity. Seeking prompt medical care for severe or concerning symptoms during a flare is also essential.
Being prepared with treatment plans, supplies, and support can help patients better cope with the ups and downs of Sjogren’s syndrome flares throughout their disease course.