Clinical Case Database / Category: Patient Management

End-stage respiratory disease: managing distressing symptoms

Publication details

Rasha Al-Qurainy MD, MRCP(UK), Philip Lodge MBBS, MRCGP
Foundation Years Journal, volume 3, issue 9, p.54 (123Doc Education, London, November 2010)


Respiratory disease is a major cause of mortality in the UK. The symptom burden is often underestimated and is comparable to the symptoms of malignant disease. End stage respiratory disease is often marked by a slow, relentless decline with prolonged periods of disability secondary to dyspnoea, reduced exercise tolerance and multiple hospital admissions. The main symptom encountered is breathlessness which can be challenging to manage. The following article describes the issues faced by a patient suffering from end stage chronic obstructive pulmonary disease and offers guidance for the management of distressing symptoms.

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Rasha Al-Qurainy MD, MRCP(UK)

ST4 Palliative Medicine
Marie Curie Hospice Hampstead

Philip Lodge MBBS, MRCGP

Consultant Palliative Medicine
ST4 Palliative Medicine
Marie Curie Hospice Hampstead


1. Watson, M, et al. Palliative care in non malignant respiratory disease. Oxford Handbook of Palliative Care. Oxford : Oxford University Press, 2006.
2. Watson, M, Lucas, C and Hoy, A. Progressive Medical Disease. Adult Palliative Care Guidance, Second Edition. s.l. : South West London, Surrey West Sussex Hampshire, Mount Vernon and Sussex Cancer Networks and Northern Ireland Palliative Medicine Group, 2006.
3. Jennings, A, et al. Opioids for palliation of breathlessness in terminal disease. Cochrane review


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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