Cough in palliative care

摘要

Chronic cough is a common and disabling symptom which has a great impact on a patient's quality of life. In palliative care, whilst it is considered as one of the difficult symptoms, the vast majority of patients can be helped by making an accurate diagnosis and its consequent management. In this patient group, multiple mechanisms can precipitate chronic cough; these can be either cancer-related or non-malignant causes. Among non-malignant causes, common conditions like gastric reflux are easily missed because of its various presentations (classic symptoms of gastro-oesophageal reflux are present in only 50% of the cases of reflux cough). In cancer patients, management of cough is dependent on the cause of coughing, and active intervention highly relies on the clinical status of the patient. This overview provides information on the physiology of cough and its causes which are needed for an accurate diagnosis, and concludes with suggestions for therapies to improve this symptom.