Wednesday, September 17, 2014

Sjogren's and Dry Mouth/Dry Eyes: Products That Help

Sjogren's is a common disorder for patients with autoimmune and rheumatic issues, either as a primary condition or secondary to other health conditions--it's characterized by very dry mouth and dry eyes and can affect many organ systems. Stomach issues can result--because the stomach does not produce enough acid to digest your food--as can genitorurinary symptoms, skin problems, etc.

Patients without Sjogren's often likewise experience very dry mouth or eyes as a side effect of a medication or multiple medications--and the result can be uncomfortable, distressing, and even painful. So rheumatology patients are not alone--cancer patients, for example, often experience the same symptoms.

If you're wondering if you have Sjogren's, the Sjogren's Foundation offers information you can look at and discuss with your doctor:

Fortunately, there is help for Sjogren's. A number of suggestions and products are listed below, but feel free to include any you like in the comments--other people can definitely benefit. These suggestions aren't intended as medical advice; please consult your specialists to find out what products will work best for you, will work with other medications that you're taking, etc.

-Biotene mouthwash, mouth lozenges, gum, and artificial saliva (this is a sweet tasting gel, not as gross as it sounds). There are other brands!
-Dental spray. I don't currently use one, but Therapsray worked well for a while. (Now that I'm writing this, I should pick up some--it really helped reduce my cavities and gave great relief.)
-Clinpro-this is a prescription toothpaste with extra fluoride for patients who have experienced many cavities.
-There are other remineralizing toothpastes and other toothpastes with fluoride that dentists recommend--check to see what works best for your situation.
-Numoisyn gel mouthwash (prescription; coats the inside of your mouth)--this is very soothing!
-Numoisyn tablets (prescription; dissolve in your mouth and moisturize it)
-Salagen (prescription; generic is pilocarpine; pills for saliva production; this bothers my heart some--I check meds with my rheumatologist as well!)
-More frequent dental cleanings (3-4x a year)--you actually save money because of fewer cavities.
-Fluoride treatment at each dental cleaning, just like the little kids do! You can also have sealants put on your back teeth again.
It's good to be vigilant with dental health to avoid cavities from lower saliva production as much as you can.
-Gum with xylitol (cavity fighting); keep away from pets--very toxic to them!
-Watch mouthwashes--many have alcohol, which dries the mouth even more. Ask your dentist about products that are alcohol free or moisturizing.

-Restasis (prescription; cyclosporine). This provides the best relief, as it addresses the cause rather than just the effects; however, there are long-term side effects, so it's worth discussing using it periodically.
-Systane and Blink. Systane makes several kinds of drops, each of which work differently; some don't work with contact lenses (so I've been told). I like their Ultra best. Recently Blink works better for me. Not sure if the formulas changed or my eyes changed.
-Contact lenses that work better for dry eyes; sometimes these can help hold in moisture for a while (CibaVision AquaComfort and Proclear)
-Eyeglasses when you have to!
-Don't forget your sunglasses--steroid use can make us more prone to cataracts over time already.
-I'm told eye masks are good for sleeping (like many people with connective tissue issues, I sleep with my eyes partially open).

For me, Sjogren's is in and of itself painful, often in an entirely different way from arthritis. A flare of Sjogren's can follow a stressful event or major pain episode. My eyes will feel dessicated and I will wake up unable to blink or close my eyes. There's no way to describe how dry your mouth feels--it's unlike any amount of dehydration. Then there's subsequent fatigue and joint/muscle pain that feels characteristically different from what I feel with an arthritis flare (especially the fatigue); it really is qualitatively different from my usual arthritis symptoms, with a different kind of rigidity. I'm curious if others feel it's different from arthritis fatigue and pain.

I hope this post is helpful to others in getting symptom relief from flares. Again, feel free to add your own suggestions in comments!

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