Bronchoscopy Procedure
Overview
Bronchoscopy is a medical test that lets doctors see inside a person’s airways and lungs using a slim instrument called a bronchoscope. This tool is usually flexible, which makes it easier for doctors to guide it through the nose or mouth, down the throat, and into the lungs.
Sometimes, if heavy bleeding occurs or a large object blocks the airway, doctors use a rigid bronchoscope. Pulmonologists, or lung specialists, usually perform bronchoscopy. Doctors use the procedure to:
- Collect mucus or tissue samples.
- Remove blockages or foreign items from the lungs.
- Treat certain lung conditions.
Common Reasons for Bronchoscopy:
- Persistent cough
- Lung infection
- Abnormal results on chest X-rays or other imaging
Why Doctors Perform This Test
Healthcare providers use bronchoscopy to examine the inside of the airways and lungs. They often recommend this procedure when someone has symptoms like a lasting cough, unexplained chest problems, or unusual findings on a chest X-ray. Main reasons for this procedure include:
- Finding the cause of lung symptoms such as coughing, wheezing, or bleeding.
- Diagnosing infections in the lungs, including cases of pneumonia.
- Detecting and testing for lung cancer or other tumors.
- Taking tissue samples (biopsies) from the lung to check for disease.
- Removing blockages like mucus, foreign objects, or growths that are blocking airways.
- Treating certain lung problems such as bleeding or narrowed airways.
- Placing devices like stents to hold airways open and help with breathing.
For people with lung cancer, doctors might use special equipment during bronchoscopy. A tool called an endobronchial ultrasound (EBUS) lets health professionals see and test lymph nodes in the chest. This helps them find out whether the cancer has spread and plan the right treatment.
| Reason for Bronchoscopy | Problem Addressed |
|---|---|
| Biopsy of lung tissue | Possible cancer or infection |
| Removal of blockage | Mucus plug, tumor, foreign body |
| Sampling lymph nodes | Checking cancer spread |
| Airway stent placement | Keeping airway open |
Possible Problems
Bronchoscopy is usually safe, but a few issues can happen. The most common problem is mild bleeding, especially if a tissue sample (biopsy) is collected. This bleeding is often minor and goes away without any special care.
Other possible problems include infection, sore throat, hoarseness, or a strong gag reflex. Some people may also have a fever after the procedure, but it usually does not mean there is an infection. A rare but serious concern is a collapsed lung (pneumothorax).
This occurs if the lung is punctured, causing air to leak and collapse the lung. Treatment sometimes requires a hospital stay. Complications from bronchoscopy are more likely in people with existing airway damage or inflammation.
| Complication | Description |
|---|---|
| Bleeding | Usually minor, stops on its own |
| Collapsed lung | Rare, may need treatment |
| Fever | Common, rarely signals infection |
| Hoarseness | Temporary, due to airway irritation |
| Infection | Uncommon, but possible |
Getting Ready for the Procedure
Eating, Drinking, and Medicines
Doctors often tell patients not to eat or drink for at least 4 to 8 hours before their bronchoscopy. Fasting is necessary to lower the risk of problems, especially if sedation, topical anesthesia, or general anesthesia is used during the procedure.
They may also ask patients to stop certain medicines, especially blood thinners, a few days ahead of time to reduce the risk of bleeding. It’s important to check which medicines should be taken, since some necessary medications might still be allowed with a small sip of water.
What to Wear and What Not to Bring
On the day of the procedure, staff usually ask people to change into a hospital gown. Patients must remove dentures, partials, or other removable dental devices. They also remove hearing aids, contact lenses, or glasses.
Other Important Steps
Because staff give sedation or numbing medicine, patients cannot drive themselves home after the exam. A responsible adult should take them home and stay with them for the rest of the day in case of side effects from the anesthesia or medicines.
What You Can Expect
Before bronchoscopy, staff seat patients or place them on a bed with arms by their sides. Monitors track heart rate, blood oxygen levels, and blood pressure. The pulmonologist or health care team uses this data to keep the patient safe.
Staff give sedative medication through an IV to help patients relax. This causes drowsiness while allowing the person to remain aware enough to respond to questions. Many people remember little about the bronchoscopy afterward, thanks to the medication.
Numbing agents, either sprays for the throat or gel for the nose, reduce discomfort and control the gag reflex. These medicines dull the area, so placing the bronchoscope is easier. The taste from these numbing medicines can be odd but fades quickly.
What Happens While the Test Is Done
The doctor inserts a flexible bronchoscope, often made of fiberoptic material, through the nose or mouth. The tool passes down the throat, over the larynx, past the vocal cords, and into the trachea and bronchi.
The bronchoscope carries a light and a tiny camera that sends video to a screen, letting the doctor view the airways directly. Sometimes, the doctor may use a rigid bronchoscope for certain therapeutic procedures. Doctors can perform various techniques through the bronchoscope:
| Technique | Purpose |
|---|---|
| Bronchoalveolar lavage (BAL) | Washes part of the lung with fluid for later study |
| Biopsy | Removes small samples of tissue or cells |
| Suctioning | Clears secretions or mucus from the airways |
| Bronchial washing/culture | Collects fluid to check for infection |
| Stent placement | Opens narrowed sections of the airway |
| Endobronchial ultrasound (EBUS) | Examines and samples lymph nodes |
| Transbronchial needle aspiration | Samples tissue from lymph nodes or tumors |
| Removal of foreign objects | Extracts items blocking the airways |
Throughout the process, the healthcare team monitors vital signs. The patient may feel pressure but should not feel pain. If discomfort or pain occurs in the chest, back, or shoulders, the doctor should be told immediately.
Recovery and What Follows
After the bronchoscopy, staff move patients to a recovery area and continue to watch heart rate, oxygen, and blood pressure. Because the numbing agent remains active for a while, eating and drinking are not allowed until feeling in the throat returns to normal.
When it’s safe, staff start with sips of water, followed by soft foods like soup or applesauce. Patients can eat regular foods once swallowing and coughing are normal again. Some people experience a mild sore throat, hoarseness, or a slight cough.
Warm water gargles or throat lozenges can help if the numbness is gone. Muscle aches are also possible, but usually improve within a day. Most bronchoscopy procedures are outpatient, so patients go home the same day once they recover.
Staff send any tissue specimens to the lab for further testing, such as culture or analysis for infection. If any of the following symptoms happen, contact a health care provider:
- Coughing up more than a few tablespoons of blood
- Fever lasting over a day
- Trouble breathing
- Chest pain that gets worse
Test Outcomes
Patients usually receive their bronchoscopy results within one to three days. Doctors may identify issues such as infections, blockages, tumors, or other airway abnormalities. If radiologists performed chest x-rays, these images may help confirm or further explain any findings.
If doctors collected a biopsy specimen, they often need more time to examine the tissue closely. Some laboratories conduct more detailed genetic tests on certain samples, which can require two weeks or more before results become available.
Key Points
- Results guide the next steps in treatment.
- Testing times vary depending on the type of sample taken.
- Patients might need additional procedures or imaging based on the findings.
