Sjögren Syndrome and Swallowing: Navigating Multisystem Impacts
Sjögren Syndrome, an autoimmune disease characterized by dry eyes and dry mouth due to inflammation of the lacrimal and salivary glands, is often associated with other autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus (Carsons & Blum, 2025). While the exact cause of Sjögren Syndrome is unknown, genetic, hormonal, and environmental factors are thought to contribute to its development (Carsons & Blum, 2025).
Xerophthalmia and xerostomia are nearly always present, with severity ranging from mild to debilitating (Carsons & Blum, 2025). Approximately 50% of individuals with Sjögren Syndrome experience involvement of other systems, including the lungs, gastrointestinal tract, kidneys, and nervous system (Carsons & Blum, 2025). Gastrointestinal manifestations can include dysphagia, dyspepsia, reflux, epigastric pain, and inflammatory bowel disease (Lin et al., 2020; Volter et al., 2004). Research indicates that patients with Sjögren Syndrome may have shorter upper esophageal sphincters, more reflux symptoms, and distinct motility patterns (Lin et al., 2020).
Patient-reported dysphagia is common, with prevalence around 60%, and disease severity is the strongest predictor of swallowing issues (Pierce et al., 2016). Patients may experience thick mucus, wheezing while eating, and the need to take smaller bites (Pierce et al., 2016). Oropharyngeal dysphagia may be attributed to salivary gland dysfunction, mucositis, and neuropathy, while esophageal motility disorders can result from loss of the esophageal myenteric plexus due to circulating autoantibodies (Furuzawa‐Carballeda et al., 2015).
Because Sjögren Syndrome can affect the entire gastrointestinal tract, particularly the larynx and esophagus, patients frequently experience dry mouth, acid reflux, epigastric discomfort, dyspepsia, and malabsorption (Lin et al., 2020; Sheikh & Shaw-Stiffel, 1995). Reduced mucosal lubrication may prolong pharyngeal transit times, impair esophageal acid clearance, and contribute to reflux symptoms such as heartburn and acid regurgitation (Lin et al., 2020).
Treatment often focuses on symptom management, though systemic approaches may be warranted depending on disease severity and multisystem involvement. To learn more about Sjögren Syndrome, check out the references cited.
Xerostomia or dry mouth.