Ask the Doctors April 2013 Issue

Ask The Doctors: April 2013

Managing Sjögren’s syndrome symptoms … RA benefits of Mediterranean diet

Q. I was diagnosed with Sjögren’s syndrome earlier this year. Thankfully, my doctor caught my condition in its early stages, but what is the best way for me to make sure my symptoms don’t get worse?

A. It’s important that patients with Sjögren’s syndrome are diagnosed early. While there is no cure for Sjögren’s syndrome at this time, there are many strategies you may use to feel better quickly, and prevent serious complications later.

The hallmark symptoms of Sjögren’s syndrome usually include severe dryness of moist body tissues, such as mouth, eyes, skin and the vagina. You may experience dryness of the nose or throat. Because these tissues are dry, complications can develop, such as infections in cracked skin, yeast infections in the vagina or eye corneal ulcers.

A rheumatologist, a doctor specializing in rheumatic diseases is best able to treat Sjögren’s syndrome. Other specialists are often important for management of your condition include an ophthalmologist (eye specialist), gynecologist (women’s reproductive specialist) and dentist. The goal is to manage your symptoms through medications, self-care and preventive strategies, and adopt healthy living practices to increase fitness and well being.

For dry eyes, you may try over-the-counter eye drops that mimic natural tears or prescription eye drops such as the cyclosporine ophthalmic emulsion. Ocular lubricant ointments are also helpful, but should only be used at night because they can cause blurred vision. Another option is a minor surgery called punctual occlusion, which plugs one of the two tear ducts in each eyelid to encourage more tears, boosting lubrication.

Maintaining good oral hygiene and seeing a dentist on a regular basis can address symptoms of dry mouth. Over-the-counter dental hygiene products, such as sodium monofluorophosphate (Biotene) gum, mouth sprays and oral rinses are very helpful, as is sipping fluids regularly.

Musculoskeletal symptoms of Sjögren’s syndrome may require your doctor to prescribe nonsteroidal anti-inflammatory drugs. Plaquenil is often prescribed for both arthritis and may have a beneficial effect on dry eyes and mouth. For those with severe complications, corticosteroids or immunosuppressive drugs may be prescribed.

Q. Are there diet  changes I can make that will help ease the symptoms of my rheumatoid arthritis? If so, what are the best foods to eat, and what should I avoid?

A. While eating certain foods or avoiding certain foods may help your rheumatoid arthritis (RA) symptoms, there is no specific “arthritis diet,” according to the Arthritis Foundation. As a general rule, if you find that certain foods worsen your RA symptoms and others help you feel better, it makes sense to adjust your diet.

To date, there is no scientific study that proves changing your diet will either aggravate or relieve symptoms. Yet, recent research shows that 30 to 40 percent of people with RA may benefit from excluding “suspect” foods that identified with an elimination diet, which can help guide you in removing suspected “trigger” foods from your daily diet. Additionally, studies show that saturated fats may increase inflammation in the body. Foods including bacon, steak, butter and cream may increase inflammatory chemicals in the body called prostaglandins. Prostaglandins cause inflammation, pain, swelling and joint destruction in RA.

It’s been shown that RA is less severe in some Mediterranean countries, such as Greece and Italy. A Mediterranean-style diet consists of large amounts of fruits, vegetables, olive oil and fatty fish high in omega-3 fatty acids. This diet may also protect against severe RA symptoms. Very high doses of omega-3 supplements have been evaluated and may provide a modest anti-inflammatory effect.