Gastrointestinal Issues Common in Primary Sjögren’s, Pilot Study Reports

Most patients with primary Sjögren’s syndrome experience gastrointestinal problems but have no recommended treatments available due to lack of information about the underlying causes, a pilot study reports.

Future studies will be needed to identify these causes and to explore the possible relationship between these symptoms and other conditions, such as depression and fibromyalgia, researchers say.

The findings were reported in the study “Abdominal symptoms during Sjogren’s syndrome: a pilot study,” published in the journal Advances in Rheumatology.

Primary Sjögren’s syndrome (pSS) is a chronic autoimmune disease of unknown origin, in which the abnormal infiltration and accumulation of immune cells inside certain glands causes inflammation and dryness.

Although abdominal and gastrointestinal problems are relatively frequent among Sjögren’s patients (found in around 25% of patients), these symptoms are still poorly documented.

Researchers in France conducted a pilot study (NCT03157011) to assess the incidence and severity of gastrointestinal issues in people with primary Sjögren’s syndrome, as well as to explore the possible relationship between these symptoms and other disease features.

A total of 150 adults (nine men and 141 women, with a mean average age of 63 years) were recruited to participate in the study, which was carried out from July 2017 to June 2018 at the University Hospital of Limoges in France.

During this period, physicians interviewed study participants to assess the incidence and severity of gastrointestinal issues using a 10-item questionnaire. A global symptom score (GSS) was also calculated for each patient, by summing the 10 individual symptom scores, which ranged from 0 (nonexistent) to 3 (severe).

Participants’ clinical and demographical data were also gathered.

From the 150 study participants, 143 (95%) had gastrointestinal problems (median GSS of 7.5 out of 30).

More than half said they experienced abdominal tension (68%), abdominal discomfort (58%), pain in the upper part of their abdomen (54%), and/or constipation (54%).

Statistical analyses also found that higher GSS scores (those greater than 10) were associated with disease activity in the joints, as measured by the Sjögren syndrome disease activity index of the European League Against Rheumatism.

Additionally, a positive correlation was found between GSS scores and the organization’s Sjögren Syndrome Patient Reported Index (which measures other disease symptoms), as well as between GSS scores and specific symptoms of the syndrome, including fatigue, dryness, and pain.

“The majority of patients with pSS suffered abdominal symptoms. There is currently no therapeutic recommendation because of the lack of information on the underlying pathophysiological [disease] mechanisms,” the researchers wrote.

“Prospective studies are needed to clarify the relationship between abdominal complaints and depressive disorders and/or fibromyalgia, and investigate the underlying pathophysiological mechanisms,” they concluded.