What is a bronchoscopy?

A bronchoscopy is a test that allows your doctor to examine your airways. Your doctor will thread an instrument called a bronchoscope through your nose or mouth and down your throat to reach your lungs. The bronchoscope is made of a flexible fiber-optic material and has a light source and a camera on the end. Most bronchoscopes are compatible with color video, which helps your doctor document their findings.

Using the bronchoscope, your doctor can view all of the structures that make up your respiratory system. These include your larynx, trachea, and the smaller airways of your lungs, which include the bronchi and bronchioles.

A bronchoscopy can be used to diagnose:

  • a lung disease
  • a tumor
  • a chronic cough
  • an infection

Your doctor may order a bronchoscopy if you have an abnormal chest X-ray or CT scan that shows evidence of an infection, a tumor, or a collapsed lung.

The test is also sometimes used as a treatment tool. For example, a bronchoscopy can allow your doctor to deliver medication to your lungs or remove an object that’s caught in your airways, like a piece of food.

A local anesthetic spray is applied to your nose and throat during a bronchoscopy. You’ll probably get a sedative to help you relax. This means that you’ll be awake but drowsy during the procedure. Oxygen is usually given during a bronchoscopy. General anesthesia is rarely needed.

You’ll need to avoid eating or drinking anything for 6 to 12 hours before the bronchoscopy. Before the procedure, ask your doctor if you need to stop taking:

  • aspirin (Bayer)
  • ibuprofen (Advil)
  • warfarin
  • other blood thinners

Bring someone with you to your appointment to drive you home afterward, or arrange for transportation.

Once you’re relaxed, your doctor will insert the bronchoscope into your nose. The bronchoscope passes from your nose down to your throat until it reaches your bronchi. The bronchi are the airways in your lungs.

Brushes or needles may be attached to the bronchoscope to collect tissue samples from your lungs. These samples can help your doctor diagnose any lung conditions you may have.

Your doctor may also use a process called bronchial washing to collect cells. This involves spraying a saline solution over the surface of your airways. The cells that are washed off of the surface are then collected and looked at under a microscope.

Depending on your specific condition, your doctor may find one or more of the following:

  • blood
  • mucus
  • an infection
  • swelling
  • a blockage
  • a tumor

If your airways are blocked, you might need a stent to keep them open. A stent is a small tube that can be placed into your bronchi with the bronchoscope.

When your doctor is finished examining your lungs, they’ll remove the bronchoscope.

Advanced forms of imaging are sometimes used to conduct a bronchoscopy. Advanced techniques can provide a more detailed picture of the inside of your lungs:

  • During a virtual bronchoscopy, your doctor uses CT scans to see your airways in more detail.
  • During an endobronchial ultrasound, your doctor uses an ultrasound probe attached to a bronchoscope to see your airways.
  • During a fluorescence bronchoscopy, your doctor uses a fluorescent light attached to the bronchoscope to see the inside of your lungs.

Bronchoscopy is safe for most people. However, like all medical procedures, there are some risks involved. Risks may include:

  • bleeding, especially if a biopsy is done
  • infection
  • trouble breathing
  • a low blood oxygen level during the test

Contact your doctor if you:

  • have a fever
  • are coughing up blood
  • have trouble breathing

These symptoms can indicate a complication that requires medical attention, such as an infection.

Very rare but potentially life-threatening risks of bronchoscopy include heart attack and lung collapse. A collapsed lung can be due to a pneumothorax, or increased pressure on your lung due to the escape of air into the lining of your lung. This results from a puncture of the lung during the procedure and is more common with a rigid bronchoscope than with a flexible fiber-optic scope. If air collects around your lung during the procedure, your doctor can use a chest tube to remove the collected air.

A bronchoscopy is relatively quick, lasting about 30 minutes. Because you’ll be sedated, you’ll rest at the hospital for a couple of hours until you feel more awake and the numbness in your throat wears off. Your breathing and blood pressure will be monitored during your recovery.

You won’t be able to eat or drink anything until your throat is no longer numb. This can take one to two hours. Your throat might feel sore or scratchy for a couple of days, and you might be hoarse. This is normal. It usually doesn’t last for a long time and goes away without medication or treatment.