What Should People with Sjögren's Avoid?

According to the Sjögren's Foundation, the disease affects an estimated 4 million Americans, but many remain undiagnosed. For those with the diagnosis, understanding what people with Sjögren's should avoid is crucial for minimizing symptoms and improving quality of life.

Quick Summary

This guide details lifestyle, dietary, and medication-related factors to avoid for managing Sjögren's syndrome symptoms effectively. It provides practical advice for minimizing triggers and reducing discomfort associated with the condition.

Key Points

• Avoid Inflammatory Foods: Steer clear of high sugar, refined carbs, processed items, and excess salt, which can trigger systemic inflammation and worsen symptoms.

• Limit Dehydrating Drinks: Reduce or eliminate caffeine and alcohol intake, as both are diuretics that can intensify dryness of the eyes and mouth.

• Scrutinize Your Medications: Discuss with your doctor which medications, such as certain antihistamines and antidepressants, might be worsening your dryness symptoms.

• Protect Against Environmental Triggers: Avoid exposure to dry, windy, or smoky environments and use humidifiers to manage indoor air moisture.

• Use Alcohol-Free Oral Products: Do not use mouthwashes containing alcohol or witch hazel, as they can further irritate and dry out the mouth.

• Quit Smoking: Smoking is extremely irritating to mucous membranes and accelerates saliva evaporation, worsening dry mouth.

• Manage Stress Effectively: High stress can trigger autoimmune flare-ups. Implement relaxation techniques to mitigate this risk.

• Practice Sun Safety: Protect your eyes and skin from excessive sun exposure, especially if you are photosensitive, by using sunscreen and protective clothing.

Understanding the Impact of Sjögren's

Sjögren's syndrome is a chronic autoimmune disease characterized by the immune system mistakenly attacking moisture-producing glands, primarily in the eyes and mouth. This results in hallmark symptoms of severe dry eyes and dry mouth (xerostomia), but it can also affect other organs and systems, causing a range of issues including fatigue, joint pain, skin problems, and inflammation throughout the body. Effectively managing this systemic condition involves more than just treating symptoms; it requires proactively avoiding certain foods, medications, and environmental stressors that can exacerbate the disease. For many, a careful and personalized approach to diet and daily habits is key to reducing the frequency and severity of flare-ups.

Foods and Drinks to Avoid

Dietary choices can significantly impact inflammation levels and dryness symptoms in people with Sjögren's. Some foods are known to act as triggers, increasing discomfort or promoting inflammation. An anti-inflammatory diet is often recommended, which means reducing or eliminating specific items. Key food and drink items to avoid include:

• Sugary and Refined Foods: High-sugar foods and refined carbohydrates (like white bread and pastries) cause blood sugar spikes, which can aggravate inflammation. High sugar intake also increases the risk of dental decay, a major concern for those with dry mouth.
• Acidic and Spicy Foods: The high acid content in foods like citrus fruits (oranges, lemons), tomatoes, and vinegar-based products can irritate and inflame an already sensitive and dry mouth. Spicy foods, such as chili peppers, can also cause a painful burning sensation.
• Alcohol and Caffeine: These substances are known diuretics and can contribute to dehydration, which worsens dry mouth and dry eyes.
• High-Sodium and Processed Foods: Excess sodium draws moisture from tissues, intensifying dryness. Processed and fried foods are typically high in unhealthy fats and added ingredients that promote inflammation.
• Gluten and Dairy: Many people with autoimmune conditions report symptom relief after eliminating these items, though reactions can be highly individual. Both can act as inflammatory triggers in sensitive individuals.
• Nightshade Vegetables: Some individuals find that nightshades (e.g., tomatoes, potatoes, peppers) trigger joint pain and fatigue, though the connection is not universally proven. An elimination diet can help determine personal sensitivity.

Medications to Discuss with Your Doctor

Certain medications can worsen dryness symptoms and should be discussed with a healthcare provider. While some medications are necessary, exploring alternatives or adjusting dosages with a doctor's guidance is important. Medications with known drying side effects include:

• Antihistamines: Many over-the-counter and prescription antihistamines, like diphenhydramine (Benadryl) and cetirizine, can exacerbate dryness.
• Tricyclic Antidepressants: Drugs such as amitriptyline and nortriptyline have significant anticholinergic effects that can increase dryness.
• Blood Pressure Medications: Some antihypertensives can contribute to dry mouth. It is important to review medications with your doctor to assess alternatives.
• Decongestants: Over-the-counter decongestants can further dry out mucous membranes, intensifying dry mouth and nasal passages.

Environmental and Lifestyle Factors to Avoid

Beyond diet and medication, several environmental and lifestyle factors can trigger or worsen Sjögren's symptoms. Protecting against these irritants is a proactive step towards better management:

• Smoking: Smoking is highly irritating to the eyes and mouth and dramatically speeds up the evaporation of saliva, worsening oral dryness and discomfort.
• Dry, Windy, and Smoky Environments: Exposure to dry air from fans, air conditioning vents, windy weather, or smoky rooms can increase eye and mouth dryness. Using humidifiers, wearing protective eyewear, and avoiding these conditions can provide relief.
• Excessive Sun Exposure: Some individuals with Sjögren's are photosensitive. Protecting skin and eyes with broad-spectrum sunscreen, sunglasses, and UV-protective clothing is vital.
• High-Stress Situations: Stress can trigger autoimmune flare-ups. Incorporating stress-management techniques like meditation, yoga, or relaxation exercises can be beneficial.
• Dry Oral Products: Using mouthwashes or rinses that contain alcohol or witch hazel can aggravate oral dryness and burning. Always opt for alcohol-free products designed for dry mouth relief.

Comparison Table: Common Triggers to Avoid

Trigger Category	Specific Items to Avoid	Potential Impact on Sjögren's	Management Strategy
Dietary	Sugary foods, acidic citrus, spicy items, high sodium, alcohol, caffeine, processed foods, excessive dairy and gluten (if sensitive).	Increases inflammation, irritates dry and sensitive mouth tissues, causes dehydration, and worsens dry eyes.	Adopt an anti-inflammatory diet; focus on soft, moist foods; stay hydrated with water; track personal food triggers.
Medications	Antihistamines, tricyclic antidepressants, some blood pressure medications, anticholinergic drugs.	Aggravates dryness of the eyes, mouth, and other mucous membranes.	Consult a doctor or pharmacist to review all medications and seek less-drying alternatives.
Environmental	Smoke, wind, dry air, air conditioning, sun exposure, low humidity.	Increases evaporation of tears and saliva, causes irritation, and can trigger flare-ups.	Use humidifiers, wear protective eyewear, avoid direct drafts, and use sun protection.
Lifestyle	Smoking, high-stress, using alcohol-based mouthwash, prolonged use of NSAIDs.	Irritates mouth, causes dehydration, exacerbates dry mouth and eyes, increases risk of dental issues.	Quit smoking, manage stress, use alcohol-free oral hygiene products, limit NSAID use.

How to Minimize Environmental Exposure

Managing environmental factors is a daily process that can significantly reduce discomfort. Beyond the basic avoidances, several other strategies can help:

• Optimizing Home Environment: Install humidifiers in bedrooms or common areas, especially during drier seasons, aiming for 55-60% humidity. Position yourself away from air conditioning vents and fans.
• Protecting Eyes Outdoors: Wear wrap-around sunglasses or moisture chamber glasses to protect your eyes from wind and sun. These minimize tear evaporation and block UV rays.
• Careful Product Selection: When cleaning, use gloves to protect your hands from harsh chemicals and strong soaps that can dry out the skin. For skin dryness, avoid perfumed or harsh soaps and use gentle, moisturizing creams.

Conclusion

Living with Sjögren's syndrome involves learning to recognize and manage personal triggers that can intensify symptoms like dryness and inflammation. Avoiding certain foods, like high-sugar, acidic, and processed items, is crucial for internal health, while being mindful of drying medications and environmental irritants helps protect against external stressors. By implementing these avoidance strategies—from dietary changes to environmental adjustments and medication reviews—individuals can better control their symptoms and significantly improve their overall quality of life. The journey is personal, but informed choices are the first step toward feeling better and more in control of your condition. Always consult with your healthcare team to create a personalized plan.(https://sjogrens.org/living-with-sjogrens/survival-tips)

Frequently Asked Questions

Which specific foods are most likely to trigger Sjögren's symptoms?

Foods most likely to trigger Sjögren's symptoms include high-sugar items, processed foods, spicy and acidic foods (like citrus and tomatoes), and those high in sodium. For some, dairy, gluten, or nightshade vegetables can also be problematic.

Can certain medications make dry eyes and mouth worse for Sjögren's patients?

Yes, several medications can exacerbate dryness, including many antihistamines, certain antidepressants (like tricyclics), some blood pressure drugs, and over-the-counter decongestants. It is crucial to review your medication list with a healthcare provider.

Why should people with Sjögren's avoid smoking?

Smoking should be avoided because it is highly irritating to the eyes and mouth, and it significantly speeds up the evaporation of saliva, thereby intensifying dryness and overall discomfort associated with Sjögren's.

How can I protect myself from environmental triggers like wind and dry air?

To protect against environmental triggers, use humidifiers indoors, especially while sleeping. When outdoors, wear wraparound sunglasses to protect your eyes. Avoid sitting directly in front of fans or air conditioning vents and stay hydrated with small sips of water throughout the day.

Are there specific oral hygiene products I should avoid?

Yes, you should avoid oral products that contain alcohol or witch hazel, as these can further irritate and dry out the mouth. Opt for alcohol-free mouthwashes and toothpastes, preferably ones formulated for dry mouth.

Is excessive sun exposure harmful for those with Sjögren's?

For individuals with photosensitivity due to Sjögren's, excessive sun exposure can cause skin reactions. Protection with broad-spectrum sunscreen, UV-protective clothing, hats, and sunglasses is highly recommended.

Does stress impact Sjögren's symptoms?

Yes, stress can exacerbate autoimmune flare-ups. Learning and practicing stress-management techniques such as deep breathing, meditation, or light exercise can help minimize its impact on your symptoms.