DEAR DR. DONOHUE: My granddaughter, 20, has Sjogren’s syndrome and rheumatoid arthritis. I tried to understand the information I found on the Internet, but I couldn’t. Will you explain this to me? – M.D.

Sjogren’s (SHOW-grins) syndrome is an autoimmune disease where the body initiates an attack on saliva and tear glands by invading them with lymphocytes, one kind of white blood cells. The attack is directed by the immune system.

Sjogren’s comes in two forms: One is the kind that exists all by itself, producing dry eyes and dry mouth and sometimes achy joints. That’s primary Sjogren’s. The other is the kind that’s associated with another illness, like your granddaughter’s rheumatoid arthritis. That’s secondary Sjogren’s. Your granddaughter has been hit with two bad illnesses. Her dry eyes make it feel like someone has thrown sand in them. The eyes burn or itch and are red. Her dry mouth makes it hard to swallow food and even to talk. She has to be diligent in caring for her teeth. A mouth without saliva is a mouth where tooth decay is rampant.

Treatment for both kinds of Sjogren’s is similar. Artificial tears – the kind without preservatives – keep eyes moist. Preservatives irritate dry eyes. Restasis eyedrops, which prod the tear glands into action, can be quite helpful. They’re not available in all countries. Eye doctors can plug tear ducts, the channels that drain tears from the eyes, to keep the eyes from drying. For dry mouth, patients should, at all times, carry a squeeze bottle with water. Sugarless gum is useful. Numoisyn Liquid is an artificial saliva that brings relief from dryness. There are many others. Numoisyn lozenges stimulate saliva production if there are remnants of the saliva glands that can still be stimulated. Salagen and Evoxac are two oral medicines that increase saliva production.

Your granddaughter has a compassionate and powerful friend in the Sjogren’s Syndrome Foundation. She and all Sjogren’s patients should contact the foundation at 800-475-6473 or on the Internet at

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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