The main symptoms of Sjögren's syndrome are dry eyes and a dry mouth, but it can also cause several other problems.

Each person is affected differently. For some people the condition may just be a bit of a nuisance, while for others it can have a big impact on their everyday life.

There are many conditions that can cause similar symptoms. See your GP if you have any symptoms you're worried about.

Dry eyes

Signs that you may have dry eyes include:

• burning, stinging or itchy eyes
• a feeling of grit or sand in your eyes
• sore, red and swollen eyelids
• discomfort when looking at lights
• sticky eyelids when you wake up
• blurred vision

These symptoms may be worse when the air is dry – for example, when you're somewhere that's windy, smoky or air conditioned.

Dry eyes can be caused by many conditions besides Sjögren's syndrome. Read more about the causes of dry eyes.

Dry mouth

Signs that you may have a dry mouth include:

• feeling like food gets stuck in your mouth or throat – especially dry food like crackers
• needing to drink water while eating to help you swallow food
• your tongue sticking to the roof of your mouth
• a hoarse voice
• a smooth, red tongue
• a change in how food tastes
• dry, sore and cracked skin at the corners of your lips
• problems such as tooth decay, gum disease, mouth ulcers, and oral thrush – a fungal infection that can cause a raw, red or white tongue

Other reasons for a dry mouth include things like diabetes or medicines. Read more about the causes of a dry mouth.

Other symptoms

Sjögren's syndrome can also cause a range of other problems.

These can include:

• dry, itchy skin
• severe tiredness and exhaustion
• vaginal dryness in women, which can make sex painful
• rashes (especially after being out in the sun)
• a dry cough that doesn't go away
• swelling between the jaw and ears (swollen salivary glands)
• muscle pain
• joint pain, stiffness and swelling
• difficulty concentrating, remembering and reasoning

Some people have other conditions closely linked to Sjögren's syndrome too, such as Raynaud's phenomenon, a condition that affects the blood supply to the fingers and toes.

Read more about the complications of Sjögren's syndrome.

See your GP if you have symptoms of Sjögren's syndrome.

They'll ask about your symptoms and look at your eyes and mouth to check for any obvious problems.

But as there are many conditions with similar symptoms to Sjögren's syndrome, it can be very difficult for your GP to diagnose.

They can refer you to a specialist for further checks if needed.

Blood tests

Blood tests can be done to look for antibodies in your blood. Antibodies are substances produced by your immune system (the body's defence against illness and infection) to attack germs.

In Sjögren's syndrome, the immune system produces antibodies that attack healthy areas of the body. These can be found during a blood test.

But not everyone with Sjögren's syndrome has these antibodies, so you may still have the condition even if a blood test doesn't find them.

Checking the layer of tears on your eyes

An eye doctor (ophthalmologist) may carry out a test to look at the layer of tears that forms across the front of your eyes.

This involves harmless coloured drops being placed in your eyes to make the layer of tears easier to see for a short time. Your doctor then looks at your eyes using a special microscope with a light.

If the layer of tears is very patchy, it could be a sign of Sjögren's syndrome.

Removing a piece of lip tissue

In people with Sjögren's syndrome, clumps of white blood cells, which are produced by the immune system, can form inside the cells where spit (saliva) is produced.

To check for this, a very small piece of tissue from the inside of your lip may be removed and looked at under a microscope. This is known as a lip biopsy.

Local anaesthetic is injected into your lip to numb it for the procedure.

Other tests

Occasionally, some other tests may be carried out. These may include:

• a spit test – you spit as much saliva as you can into a cup over a five-minute period and the amount is then measured or weighed
• measuring how many tears you produce – small strips of paper are placed in your lower eyelid for five minutes to see how much of the paper is soaked with tears

Producing less saliva or fewer tears than normal can be a sign of Sjögren's syndrome.

There's currently no cure for Sjögren's syndrome, but there are treatments that can help relieve the symptoms.

Treatments for dry eyes

Things you can do

If you have dry eyes, it can help to:

• avoid dry, smoky or windy places – it may help to use a humidifier at home or work to keep the air moist
• avoid reading, watching TV or looking at screens for a long time – this can dry your eyes out
• wear wraparound sunglasses or glasses with sides that help stop wind drying out your eyes
• clean your eyelids regularly – read more about how to keep your eyelids clean
• have regular check-ups with an optician
• avoid medicines that can cause dry eyes – check the leaflet that comes with a medicine to see if dry eyes is listed as a side effect

Eye drops and ointments

You can also try eye drops and ointments that help keep your eyes wet, sometimes known as artificial tears.

There are several different types of drops that can be bought from pharmacies without a prescription. You may need to try a few types to find one that works for you.

If you use eye drops more than three times a day, avoid drops that contain preservatives as these can damage your eyes if used frequently.

If the surface of your eye is irritated (inflamed), your doctor may prescribe drops containing steroids to use for a short period.

Sometimes other anti-inflammatory drops, such as ciclosporin drops, may be prescribed by an eye specialist.

Medicines and procedures

If self-help measures and eye drops aren't helping, your doctor may recommend:

• a medicine called pilocarpine – tablets that help the body produce more tears and saliva (read about medicines for a dry mouth for more information)
• a procedure to block the tear ducts with tiny man-made plugs to stop tears draining away – this can help keep your eyes covered with a layer of tears, so they don't feel as dry

Treatments for a dry mouth

Things you can do

If you have a dry mouth, it can help to:

• practise good oral hygiene – including brushing your teeth with fluoride toothpaste twice a day
• avoid sugary food and drinks, and avoid snacking between meals
• use antibacterial mouthwash
• drink plenty of water
• regularly chew sugar-free chewing gum or suck on ice cubes
• use lip balm if your lips are dry and cracked
• avoid alcohol – read advice about cutting back on alcohol
• stop smoking if you smoke
• have a dental check-up at least every six months
• avoid medicines that can cause a dry mouth – check the leaflet that comes with a medicine to see if dry mouth is listed as a side effect

Saliva substitutes

There are also products you can buy from pharmacies that help keep the mouth moist – known as saliva substitutes.

There are several different types available, including sprays, lozenges (medicated sweets) and gels. You may need to try a few types to find one that works for you.

But these products don't help prevent mouth infections in the same way that saliva does, so it's still important to practise good oral hygiene.

Medicines

The medicine pilocarpine can be used to treat a dry mouth and eyes. It comes as tablets that help the body produce more saliva and tears.

But it isn't suitable for everyone and can cause some side effects, such as sweating, headaches, and needing to pee more often than normal.

If your doctor recommends pilocarpine, talk to them about the benefits and risks of taking it.

Treatments for other common symptoms

Dry skin

If you have dry skin, it may help to use a moisturising cream (emollient) every day.

It's also a good idea to avoid strong, perfumed soaps. Use emollient soap substitutes instead.

Read more about emollients and soap substitutes.

Vaginal dryness

Treatments for vaginal dryness include:

• lubricants – liquids or gels that you apply to your vagina just before having sex for immediate relief from dryness
• moisturisers – creams that you apply inside your vagina to keep it moist for a few days
• hormone treatments – such as oestrogen medication you place in your vagina, or hormone replacement therapy (HRT)

Read more about treatments for vaginal dryness.

Muscle and joint pain or stiffness

If you have pain or stiffness in your joints or muscles, it can help to:

• exercise regularly – a mixture of aerobic exercises (such as cycling)and strength and flexibility exercisesmay be helpful; a physiotherapist can recommend a suitable exercise plan
• take anti-inflammatory painkillers, such as ibuprofen – your GP may prescribe stronger painkillers if these don't work
• lose weight if you're overweight

A medication called hydroxychloroquine is sometimes recommended by Sjögren's syndrome specialists as a treatment for joint pain or stiffness if other methods haven't helped.

But it isn't suitable for everyone and can take several months to work. It can also cause side effects such as tummy pain and feeling sick.

Sjögren's syndrome can sometimes lead to further problems or occur alongside other conditions.

Eye problems

If you have very dry eyes and they're not treated, there's a risk the front layer of your eyes could become damaged over time.

If this isn't spotted and treated, it could lead to permanent problems with your vision.

There are several treatments for dry eyes that can help reduce this risk. You should also have regular check-ups with an optician so any problems are picked up early on.

Contact your GP as soon as possible if you have problems with your vision.

Lung problems

Sometimes Sjögren's syndrome can affect the lungs and cause problems such as:

• lung infections
• widening of the airways in the lungs (bronchiectasis)
• scarring of the lungs

If you smoke, stopping may help reduce the risk of these conditions. Read more advice about stopping smoking.

See your GP if you develop a cough, wheezing or shortness of breath that doesn't go away.

Pregnancy complications

Most women with Sjögren's syndrome can get pregnant and have healthy babies.

But if you're planning a pregnancy, it's a good idea to get advice from your GP or specialist because there's a small risk of complications in some women.

These include:

• a rash in the baby that lasts a few weeks
• serious heart problems in the baby

These problems can occur if you have certain antibodies (produced by the immune system) sometimes found in people with Sjögren's syndrome. A blood test can be done to look for these.

If these antibodies are found, you can still get pregnant, but you may need additional specialist care during pregnancy and after the birth.

Cancer

People with Sjögren's syndrome have an increased risk of developing a type of cancer called non-Hodgkin lymphoma.

This affects the lymphatic system, a network of vessels and glands found throughout the body.

Research suggests people with Sjögren's syndrome are about five times more likely to get non-Hodgkin lymphoma than those who don't have the condition, but the chances of getting it are still small.

See your GP if you develop symptoms of non-Hodgkin lymphoma, such as:

• painless swollen glands, usually in the neck, armpit or groin
• night sweats
• unintended weight loss 

Non-Hodgkin lymphoma can often be cured if it's caught early on.

Other problems

A number of other conditions have been linked to Sjögren's syndrome, including: 

• Raynaud's phenomenon – restricted blood flow to the hands and feet, which can cause them to feel cold, numb and painful
• an underactive thyroid gland (hypothyroidism) – which can cause tiredness and weight gain
• irritable bowel syndrome (IBS) – which can cause tummy pain, diarrhoea or constipation
• peripheral neuropathy – a condition that causes loss of sensation in the hands and feet
• kidney problems – such as kidney inflammation or kidney stones
• inflammation of the blood vessels (vasculitis) – which can cause a rash that looks like small bruises or reddish-purple spots