This questionnaire may be printed from the Screen, filled in and may be helpful in discussions with your doctor.
Symptom
Yes
No
Oral
Dry mouth
Sore mouth
Difficulty in chewing
Difficulty in swallowing
Change in taste
Symptom
Yes
No
Ocular
Dry eyes
Ocular discharge
Itchy eyes
Sandy feeling
Foreign body sensation
Tired eyes
Intolerance to light
Symptom
Yes
No
Nose
Dry nose
Recurrent sinusitis
Bleeding nose
Symptom
Yes
No
Vagina
Dry vagina
Vaginal burning
Recurrent candidiasis
Symptom
Yes
No
Gastric
Hyper acidity/reflux
Indigestion
Diarrhea
Constipation
Symptom
Yes
No
Pulmonary
Chronic cough
Recurrent bronchitis
Symptom
Yes
No
Skin
Dry skin
Skin rash
Burning skin
Symptom
Yes
No
Others
Arthritis
Muscle pain
Psychological disorders
Thyroid gland disorders
Statistical analysis showed that combined symptoms of dry mouth, sore mouth, and dry eyes symptoms, correctly classified 93% of SS and
97.7% of the controls. Excluding mouth and eyes, combined gastric, muscle, psychological, vaginal, skin, nasal, and thyroid symptoms correctly classified 64.3% of SS and 86.1% of the controls.
