Bronchoscopy

What is a bronchoscopy?

Bronchoscopy is a minimally invasive procedure that lets your healthcare provider look inside your airways and lungs with a bronchoscope. A bronchoscope is a thin tube with a light and camera on it. It can help your provider diagnose, evaluate and sometimes treat conditions that affect your lungs, trachea (windpipe) or throat.

Bronchoscopes can be either rigid or flexible:

• A flexible bronchoscope is a bendable tube. Providers use it more often because they can move it more easily down your airway. They use it to keep your airway open, take a tissue sample (biopsy) or suction secretions.
• A rigid bronchoscope is a firm tube. Providers use it when you have a large object stuck in your airway or when more difficult procedures — like putting in stents or treating tumors or bleeding — are needed.

What does a bronchoscopy diagnose?

A healthcare provider may recommend bronchoscopy to find the cause of lung problems you may be experiencing. Some of the most common are:

• Diagnosing lung disease or other causes of symptoms like excessive coughing, coughing up blood or shortness of breath.
• Following up after an X-ray or CT scan (computed tomography scan) showed possible signs of cancer.
• Assessing and removing blockages or treating narrowed areas in your airways.
• Determining causes of infection or inflammation in your lungs.
• Taking samples of mucus or tissue to send to a lab for analysis.
• Placing a stent (small tube) to keep your airway open.

How do I prepare for bronchoscopy?

Your healthcare providers will give you specific instructions about how to prepare for a bronchoscopy.

But, in general, you’ll need to fast (not eat or drink) for a certain amount of time before the procedure. You may also have to stop taking certain medications like blood thinners or diabetes medication. Be sure to tell your provider about any medications, herbs or vitamins you take.

Your healthcare provider will give you a sedative for the procedure. You should plan on having someone available to drive you home afterward.

Do you need a CT scan before a bronchoscopy?

Unless you’re in an emergency situation, your healthcare provider will likely order a CT scan before a bronchoscopy. A CT scan of your lungs can help your provider evaluate lung diseases and conditions like cancer or lung damage from smoking cigarettes to help decide if a bronchoscopy is needed.

What happens during a bronchoscopy?

A pulmonologist typically performs a bronchoscopy in a hospital or surgical center as an outpatient procedure. This means you can go home after the procedure.

You’re typically given some medication to be sleepy and comfortable. Rigid bronchoscopy and many procedures that involve biopsies may require general anesthesia (being asleep). You should discuss which kind of anesthesia your procedure will require with your healthcare provider.

In most cases, a bronchoscopy follows these steps:

• Your provider inserts an IV into your arm to deliver a sedative to help you relax.
• You lie on a bed or table with your head propped up.
• Your provider may apply a numbing spray to your mouth (or nose) and throat. This helps with any discomfort you may feel when they insert the bronchoscope.
• Once the area is numb and you’re under sedation, your provider inserts the bronchoscope through your nose or mouth or through a tube, while you’re under anesthesia, and down into your windpipe to your lungs.
• Your provider may suction saliva (spit) from your mouth since you won’t be able to swallow.
• After the procedure, your provider gently removes the bronchoscope. Your healthcare team monitors your condition until you’re fully awake.

Do they put you to sleep for a bronchoscopy?

Most of the time, you’ll be sleepy, at least, if not asleep. It depends on what type of bronchoscopy you’re having and what your healthcare provider is diagnosing. Many people have the procedure with general anesthesia, and only some procedures can use a local anesthetic (numbing medicine).

How long does a bronchoscopy take?

You can expect a bronchoscopy to last 30 to 90 minutes. The exact timing depends on why your provider is performing the procedure.

What happens after a bronchoscopy?

In most cases, bronchoscopy is an outpatient procedure, so you won’t need to spend the night in the hospital. You can typically go home within a few hours of the procedure.

Your healthcare team will monitor you after the procedure to ensure you’re breathing and swallowing properly. Your provider may decide to order a chest X-ray after the procedure to check for any signs of problems.

You may have a numb throat for up to an hour. You may have a sore throat, cough or hoarseness for the next 24 hours. Using cough drops can help with this. Most people can return to normal activities the next day. Your healthcare provider will let you know if you should restrict your activities in any way.

Your healthcare team will let you know when you should expect test results and when you should schedule a follow-up appointment.

How long are you in recovery after bronchoscopy?

You can expect to spend at least 45 minutes recovering, if not longer. Your healthcare team needs to monitor you while the sedation or anesthesia wears off and make sure your vital signs are normal. They also want to make sure you don’t experience any irregular side effects after the procedure.

Can I eat and drink after a bronchoscopy?

You shouldn’t eat or drink until the numbness wears off, which could take an hour or more. Once you don’t feel numb, start by sipping water and eating soft foods. Eating and drinking too soon could cause you to breathe the food or drink into your lungs (aspirate) or choke.

What are possible complications during a bronchoscopy?

Bronchoscopy is a very safe procedure, but there’s a slight risk of:

• A hole in your airway.
• Irritation or inflammation of your vocal cords.
• Lung collapse (pneumothorax).

In most cases, healthcare providers use a flexible bronchoscope, not the rigid bronchoscope. This is because the flexible type is easier to move around your airways and throat. And it provides better access to smaller areas of lung tissue. But some situations require a rigid scope.

Be sure to discuss the risks of a bronchoscopy before surgery. Ask your provider if you’re at a higher risk for complications.

How long does it take to get the results of a bronchoscopy?

Ask your healthcare team when you can expect results. If they took biopsies during the procedure, the results should be available within one week. Other test results may be available sooner or later depending on the kind of testing.

Your healthcare provider will use the results to determine the next steps of your care. This varies from person to person depending on what your provider finds during the bronchoscopy.

When should I contact my healthcare provider?

Call your healthcare team if you have any of the following symptoms, which can indicate an infection, collapsed lung or other problem:

• Chest pain.
• Difficulty breathing.
• Persistent fever.
• Persistent cough or coughing up blood.
• Signs of pneumonia.