Dry Mouth: Salivary Gland Function and Reactive Arthritis

Q: Dry Mouth: Salivary Gland Function and Reactive Arthritis

Hello, thank you for your question. <br>Here are my responses：<br>1. <br>My doctor told me that my salivary gland function is impaired, likely due to arthritis-related xerostomia, which is different from typical dry mouth. <br>Can reactive arthritis also lead to symptoms of dry m

Sjögren's syndrome and sialography?

Hello Doctor, (I forgot to attach the data and there were some missing words, so I am asking again.) My immunologist diagnosed me with possible reactive arthritis.
Recently, after hearing that I have dry eye syndrome, the doctor arranged for a salivary gland scan.
The report data is as follows: 1/15/30 minutes: Right parotid 2.90/6.81/3.52, Left parotid 6.61/15.60/6.37, Right submandibular 6.85/7.78/4.16, Left submandibular 10.1/12/6.2.
The doctor's diagnosis is as follows: 1.
Excretory dysfunction at the right submandibular gland (Discharge curve shows no definite response post-acid stimulation at the right submandibular gland) 2.
Rule out inflammation at the left parotid gland.
I would like to ask you: 1.
My doctor told me that my salivary gland function is relatively poor, which should be due to the arthritis causing dry syndrome, and it is different from typical dry syndrome.
Can reactive arthritis also lead to symptoms of dry syndrome? Is it possible that my salivary gland function will improve after my arthritis symptoms improve? 2.
Should I suspect that I have other autoimmune diseases? Do I need to undergo a biopsy? 3.
Besides autoimmune diseases, are there other causes or conditions that could lead to my excretory dysfunction? 4.
I do not feel dry mouth during the day, only when I wake up (but people around me think the morning dryness is normal).
The doctor prescribed me Aiwujin capsules as a backup; do I need to use this regularly long-term, or should I only use it when I feel dry mouth? Thank you for your response!

Jade, 30~39 year old female. Ask Date: 2023/05/06

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my responses:
1.
My doctor told me that my salivary gland function is impaired, likely due to arthritis-related xerostomia, which is different from typical dry mouth.
Can reactive arthritis also lead to symptoms of dry mouth? Is it possible that my salivary gland function could improve after my arthritis symptoms improve? --> Reactive arthritis is less commonly associated with xerostomia, but treatment of reactive arthritis may improve dry mouth symptoms.
2.
Should I suspect that I have other autoimmune diseases? Do I need to undergo a biopsy? --> You can first ask your rheumatologist to assess whether further blood tests are necessary.
If there are still no answers, consult your primary physician about the need for a salivary gland biopsy.
3.
Besides autoimmune diseases, are there other causes or conditions that could lead to my excretory dysfunction? --> Other causes need to be ruled out, including viral hepatitis, thyroid disorders, and medication side effects.
You can discuss this with your primary physician.
4.
I do not experience dry mouth during the day, only upon waking (though those around me think my morning mouth feels normal).
My doctor prescribed Amlodipine capsules for me to use as needed.
Should I use this regularly, or only when I feel dry mouth? --> You can use it as needed when you experience dry mouth.
Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2023/05/06

More Info

Understanding the relationship between dry mouth (xerostomia), salivary gland function, and reactive arthritis is crucial for managing your symptoms and overall health. Let's address your questions systematically.

1. Can reactive arthritis lead to dry mouth symptoms?
Reactive arthritis is primarily an inflammatory condition that can occur after an infection, often affecting the joints. While it is not commonly associated with dry mouth, autoimmune conditions can have systemic effects, including on salivary glands. Conditions like Sjögren's syndrome, which is characterized by dry mouth and dry eyes, can sometimes overlap with other autoimmune disorders. If your reactive arthritis is part of a broader autoimmune process, it might contribute to your salivary gland dysfunction. Improvement in your arthritis symptoms may lead to some improvement in salivary gland function, but this is not guaranteed. It is essential to monitor your symptoms and discuss them with your healthcare provider.

2. Should I suspect other autoimmune diseases? Is a biopsy necessary?
Given your symptoms and the findings from your salivary gland scan, it is reasonable to consider the possibility of other autoimmune diseases, particularly Sjögren's syndrome. A thorough evaluation by a rheumatologist or immunologist can help determine if further testing, such as blood tests for specific autoantibodies or a salivary gland biopsy, is warranted. A biopsy can provide definitive evidence of autoimmune damage to the glands, but it is typically considered when there is a strong suspicion of a condition like Sjögren's syndrome.

3. What other conditions could cause excretory dysfunction?
Excretory dysfunction in the salivary glands can arise from various causes beyond autoimmune diseases. These include viral infections (like mumps), certain medications (such as antihistamines or antidepressants), dehydration, and systemic diseases like diabetes or thyroid disorders. It is essential to discuss these possibilities with your healthcare provider, who may recommend additional tests to rule out these conditions.

4. Regarding the use of saliva substitutes like Aiwujin capsules:
If you are experiencing dry mouth primarily upon waking, it may not be necessary to use saliva substitutes regularly. Many people experience transient dry mouth upon waking due to overnight dehydration or mouth breathing. Using the capsules as needed, particularly when you feel dry, is a practical approach. However, if you find that your symptoms persist or worsen, it would be wise to consult your doctor for further evaluation and management options.

In summary, while reactive arthritis is not typically linked to dry mouth, the interplay of autoimmune conditions can complicate the picture. It is essential to maintain open communication with your healthcare team, who can guide you through the necessary evaluations and treatments. Regular follow-ups will help monitor your symptoms and adjust your management plan as needed.

Similar Q&A

Understanding Dryness Syndrome: Symptoms, Diagnosis, and Tests

Hello Doctor: Two years ago, I experienced joint swelling and inflammation in my little finger. My family doctor recommended tests, including rheumatoid arthritis (RA) and anti-citrullinated protein antibody (CCP) tests, both of which returned normal results. Recently, I have not...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your inquiry. Sjögren's syndrome requires a detailed medical history, which includes not only questions about dry mouth but also inquiries about dry eyes and even respiratory symptoms. Blood tests should be arranged, including screening for antinuclear a...

Understanding Dry Syndrome and Joint Cartilage Issues: A Guide to Immune Disorders

Hello, Director Gao! I have several symptoms and I'm unsure if they are related to an autoimmune disease. 1. My dentist informed me that my mouth is very dry. This condition has persisted for at least three years, especially during sleep when it is particularly dry (I cann...

Dr. Gao Jiankai reply Internal Medicine
Hello, I apologize for the late response. I believe your symptoms are indeed related to Sjögren's syndrome, including dry eyes, dry mouth, thyroid dysfunction, cough, and generalized body aches, even lower back pain, which may all be associated with Sjögren's syndrome. ...

Chronic Dry Mouth and Tongue Pain: Unraveling the Mystery of Symptoms

Hello Doctor, my mother has been experiencing symptoms of reduced saliva for about 30 years. She has seen dentists, rheumatologists, and family medicine doctors, and underwent a sublingual gauze test which confirmed the decrease in saliva. However, no physician has been able to i...

Dr. Gao Jiankai reply Internal Medicine
Hello, thank you for your inquiry. My suggestions are as follows: 1. You may consider returning to a rheumatology clinic for evaluation. If necessary, a salivary gland biopsy may indeed be required, as sometimes the diagnosis of Sjögren's syndrome necessitates this examina...

Understanding Churg-Strauss Syndrome: Symptoms and Treatment Options

Sjögren's syndrome is an autoimmune disorder characterized by the body's immune system attacking its own moisture-producing glands, leading to dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). Treatment typically focuses on alleviating symptoms and may i...

Dr. Zeng Guosen reply Internal Medicine
Hello, Sjögren's syndrome, commonly known as dry syndrome, is caused by immune dysfunction that leads to the impairment of exocrine gland function, resulting in dry mouth, dry eyes, or enlargement of the exocrine glands, as well as involvement of other joints and internal or...