Dear Dr. B: What is Sjogren’s syndrome?

Answer: Sjogren’s (pronounced “show-grins”) syndrome is a chronic autoimmune disorder in which body’s own antibodies (immune cells) attack and destroy the glands that produce tears and saliva. The syndrome was first described by Swedish ophthalmologist Henrik Sjögren (1899-1986). The syndrome is also associated with rheumatic disorders such as rheumatoid arthritis.

Why do our own immune cells turn against us? We don’t know. It may have some thing to do with our genes.

Patients with Sjogren’s syndrome present with dry mouth and dry eyes. The condition may also cause skin, nose and vaginal dryness. It may affect other organs of the body such as kidneys, blood vessels, lungs, liver, pancreas and brain.

The condition is more common between the ages of 40 and 60 but it may occur at any age. It is more common in females. About four million people in the U.S. are affected by Sjogren’s syndrome.

Because of the involvement of many organs, a patient may present with multiple symptoms. This makes diagnosis difficult. But there are several tests available to confirm the diagnosis of Sjogren’s syndrome.

Blood tests are done to check if a patient has high levels of antibodies. A strip of filter paper is used to check for production of tears. There is a test to check for dryness on the surface of the eyes A biopsy of the lip or salivary glands can be done to check for damaged cells.

Is there a cure for the problem? Unfortunately, no. There is neither a known cure for Sjögren’s syndrome nor a specific treatment to permanently restore gland secretion. Treatment is symptomatic and supportive such as artificial tears, goggles and increased local humidity to protect the eyes.

Medications are used to increase salivary flow. Steroids or immunosuppressive drugs are used for symptomatic relief of other symptoms. Prognosis for this condition is variable depending on the severity of the disease process.

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What is the most important meal of the day?

Most people know that the most important meal of the day is breakfast. It is the first meal of the day after prolonged overnight fast. A good breakfast should provide us with enough calories and should be healthy. It should curb our hunger later in the day so the total amount of calories consumed is less.

Dr. Khursheed Jeejeebhoy, a highly respected gastroenterologist and professor of medicine at the University of Toronto reviewed some literature and wrote an article in the Medical Post on this subject. He concluded that on the basis these studies, a good way to avoid overeating is to eat a breakfast rich in protein and fiber on a regular basis with fish meals thrown in. Fish protein is better than beef protein in reducing daily energy intake. So make it a point to enjoy a healthy breakfast everyday.

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