Sjogren’s Syndrome: An Ayurvedic Perspective

Sjogren's Syndrome: An Ayurvedic Perspective

Sjogren’s syndrome is a long-term autoimmune disease that primarily affects the endocrine glands. The lacrimal and salivary glands are mainly involved and describe symptoms like dry mouth and dry eyes, and in extreme cases, they affect the lungs, kidneys, and nervous system. An estimated prevalence of Sjogren’s syndrome across the world is 22.0-770.0 per 100,000 people. The study also found that women are about 20 times more likely to be affected by the condition than men.

In Sjogren’s syndrome, the immune system creates inflammation, which destroys tissues and sends nerve signals to specific glands throughout the body. The inflammation mostly targets glands that generate fluids, such as the lacrimal glands beneath the eyelids and the salivary glands in the mouth. This reduces how much saliva, tears, and other fluids the glands produce. Now, if we view Sjogren’s syndrome from an Ayurvedic perspective, it will boil down to an imbalance in dosha. Let’s see how Ayurveda elaborates on this condition.

Ayurvedic perspective on Sjogren's syndrome

Sjogren’s syndrome is termed as “Shushkakshipaka” in Ayurveda. It can be divided into two words: ‘Shushka’ means ‘dryness’ and ‘Paka’ means ‘inflammation’ of Netra. It falls under the Sarvagata Netra Roga, a Vata/Vata-Pitta dominant vyadhi. It also causes metabolic and tissue disorders. Rasa, Meda, and Majja Dhatus combined to create Ashru. It is derived from Rasa Dhatu, which restores nutrients to the outer tunics. When this is compromised, Sjogren’s syndrome develops. It shows Vata dosha dushti, leading to Sandhigata vikara, Roukshya, and Shushkakshipaka. Shushkakshipaka is vata-pittaja, Sarvagata Netra vikara that matches the clinical picture of dry eye disease.

Classification of Sjogren’s syndrome

Sr. No.	Type	Presentation of disease
1	Primary	Disease is alone
2	Secondary	Associated with other autoimmune disease
3	Glandular	Seen within exocrine glands
4	Extra glandular	Other body tissues include arthralgia, arthritis, lymphadenopathy, lung involvement, vasculitis, kidney-liver involvement, lymphoma, splenomegaly, peripheral neuropathy, and myositis.

Samprapti Ghatak in Sjogren syndrome according to Ayurveda

Dosha	Vata, Pitta, Kapha (Vata pradhan)
Dhatu	Rasa, Rakta
Strotas	Rasavaha, Raktavaha, Udakvaha
Stroto dusti type	Sang
Agni	Mandya
Vyadhi bala	Madhyam
Sadhya-asadhyata	Kruchsadhya
Vayadhi marg	Abhyantar and Bhaya
Udhbhava sthana	Amashya
Vyadhi adhisthana	Bahya Stravi Granthi
Updrava	Lymphoma

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Investigation of samprapti reveals that hetu, i.e., sannikrutha hetu in Sjögren syndrome, is a genetic predisposition, and viprakrushta hetu here is unwholesome food and living habits; amla padarth sevan (sour food); vidahi padarth sevan (acidic food); aagantuj hetu here can be infection; and environment factors can be considered as one of the reasons for vitiation of Vata, Pitta, and Kapha. Vitatied doshas and mithya aahar lead to Agni Mandya and Ama Nirmiti. This Ama is caused by incompletely digested food in amashya. This aahar rasa with Ama travels throughout the body via specialised channels known as rasavaha strotas. This rasavaha strotas transports Ama, a poison, throughout the body, affecting the mul sthana, sthool poshnan, and sushma poshak bhaga. Ultimately, it influences hrudaya, dashdhAmani, rakta poshak bhag dushti, and swa poshan dushti.

During digestion, digested food (aahar rasa) is absorbed by the small intestine and transported to the bloodstream in two ways: directly into the lymphatic system or through the portal vein to the liver, where it undergoes metabolic transformation before entering the systemic circulation. This gives an understanding of dhatu poshan nyaya in Ayurveda, as well as the role of healthy and unhealthy food eating habits and their repercussions after absorption leads to health and disease, respectively. Ama in aahar rasa impairs the Prinan function of rasa dhatu in the early stages of illness progression. The continuance of mithya aahar and associated vihar, i.e., external factors, leads to prakop and prasar. The body’s fighting system is activated as a result of the toxin in rasa and rakta. This Ama dushit rasa-rakta and prakopita doshas travel and settle at exocrine glands, i.e., lacrimal and salivary glands, which are the sites of kapha dosha, causing sthanik dosha dusti, i.e., tarpak kapha in the eyes, resulting in dryness of the eyes, and bodhak kapha in the mouth, resulting in dryness of the mouth.

Treatment of Sjogren’s syndrome in Ayurveda

The Ayurvedic method of treatment involves removing poisons from the body. This process includes therapies such as Vamana, Virechana, Poorvabhisamskaar, Rasayana Prayoga, and Raktamokshana. The treatment is related to the consumption of herbs such as Ashwagandha and Haridra, which are believed to increase the immune system, and Ojas. These herbs, coupled with therapies, aid in the elimination of toxins from the body as well as the restoration of normal healing and function. This method of treatment helps to reverse the illness naturally.

Ayurvedic therapies for Sjogren’s syndrome are:

Ayurvedic Therapies	Purpose	Herbs/ Types/ Procedure	Application
Deepan Pachana Deepan: Stimulating digestive fire to enhance metabolism Pachan: Aiding the digestion of toxins (ama) accumulated in the body	Enhances digestion, reduces toxin accumulation, and balances the doshas, especially useful for improving overall digestive health which is foundational in Ayurveda.	Herbs: Pippali (long pepper), ginger, black pepper, cumin, and other digestive herbs.	Before starting other treatments to ensure the body is ready for detoxification and nourishment.
Mridu Virechan: Gentle purgation therapy	Cleanses the bowels and removes toxins, particularly targeting Pitta dosha-related toxins. This can help reduce systemic inflammation and dryness.	Herbs: Mild laxatives like Triphala, castor oil, or specific herbal formulations.	Used periodically to maintain internal cleanliness and balance.
Basti: Medicated enema therapy	Balances Vata dosha, which is often aggravated in autoimmune disorders. Basti helps in detoxifying the colon, improving hydration, and providing nourishment.	Types: Anuvasana Basti: oil-based enemas for lubrication and nourishment. Niruha Basti: Decoction-based enemas for detoxification.	Administered in a series, alternating between Anuvasana and Niruha for comprehensive benefits.
Seka: Pouring of medicated liquids over the affected areas	Treats eye dryness and inflammation by pouring herbal decoctions or oils over the eyes.	Procedure: Warm herbal decoctions or medicated liquids are gently poured over the eyes.	Provides immediate relief and hydration to dry eyes
Aschyotan: Eye drop therapy	Provides relief from eye dryness, irritation, and inflammation.	Procedure: Medicated eye drops made from herbal extracts are applied to the eyes.	Used regularly to maintain moisture and health in the eyes.
Akshi Tarpan: Eye nourishment therapy	Nourishes and lubricates the eyes, relieving dryness and improving vision.	Procedure: The eyes are bathed in a pool of medicated ghee (clarified butter) for a specified period of time.	Performed periodically to deeply nourish and rejuvenate the eyes.
Nasya: Nasal administration of medicated oils	Lubricates the nasal passages, improves respiratory functions, and balances the doshas in the head region. It can help with dryness of the nasal passages and related structures.	Procedure: Medicated oils or powders are administered through the nostrils.	Done daily or periodically to maintain moisture and health in the nasal passages and sinuses.
Anjana: Application of medicated ointments	Helps in treating various eye disorders, including dryness, by applying herbal pastes or ointments to the inner side of the eyelids.	Procedure: Specific herbal preparations are used to line the inner eyelids.	Used regularly or as needed to treat and prevent eye dryness.

Summary

Ayurvedic remedies can help manage Sjogren’s syndrome holistically by addressing underlying imbalances in the body as well as immediately treating dryness in the eyes, mouth, and other mucous membranes. Consultation with a skilled Ayurvedic practitioner is essential for tailoring these treatments to your unique requirements and ensuring their safe and successful application.