Bronchoscopy

Bronchoscopy is a medical procedure for diagnosing and treating lung conditions. Your health care provider might order this test if you’ve been coughing or experiencing discomfort in your lungs or chest.

At Banner Health, we’re committed to guiding you through the bronchoscopy process. Read on to learn more about this procedure and what to expect before, during and after.

What is a bronchoscopy?

A bronchoscopy is a medical procedure that examines the lungs and air passages using a lighted tube called a bronchoscope. A specialist known as a pulmonologist typically performs bronchoscopies in a hospital or an outpatient setting. 

The tube is gently guided through your mouth or nose, down your throat and windpipe (trachea) and into your lungs. This lets your provider see your voice box (larynx), trachea and large- and medium-sized airways. Sometimes, a piece of tissue or fluid is removed to be tested in a lab (a biopsy).

Types of bronchoscopy

There are two types of bronchoscopes: flexible and rigid. 

1. Flexible bronchoscopy is used more often because it can easily navigate the airways to look at hard-to-reach areas. It usually does not require sedation or general anesthesia (medicine to help you relax and sleep).
2. Rigid bronchoscopy uses a bigger tube that does not bend much, which makes it good for dealing with serious problems like heavy bleeding in the airway or removing something from the airway. It is usually done under general anesthesia, so you are asleep for the test.

Why might I need a bronchoscopy?

A bronchoscopy is usually performed to find and treat lung problems. Your provider might recommend a bronchoscopy to:

• Find out the cause of chronic coughing, wheezing, trouble breathing, coughing up blood or frequent lung infections
• Follow up after an abnormal chest X-ray or CT scan
• Collect mucus or tissue samples
• Remove mucus or objects that are blocking airways
• Place a stent (small tube) to keep airways open
• Control bleeding or remove abnormal growths or tumors
• Place a breathing tube to help give oxygen

Possible complications of a bronchoscopy

Bronchoscopy is a very safe procedure. But like other endoscopies, it has some risks: 

• Bleeding
• Reaction to the sedative or general anesthesia
• A sore throat or hoarseness
• A small tear or hole (perforation) in your airway can lead to complications like a collapsed lung (pneumothorax) or airway injury

In most cases, pulmonologists use flexible tubes because they are softer and less likely to cause damage. They also give clearer pictures of the lungs and are more comfortable. 

If you have any worries or questions about getting a bronchoscopy, it's important to talk to your provider. They’ll help you understand everything and ensure your safety during the procedure.

How to prepare for a bronchoscopy

Your provider will give you instructions on how to prepare, but here are a few steps to ensure everything goes smoothly:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider if anything is unclear.
• Adjust medications: Your provider may ask you to adjust or temporarily stop your medications and/or dosage, especially blood thinners, to reduce the risk of bleeding during the procedure. If you have ongoing conditions such as diabetes or heart disease, your provider will give you specific instructions about your medications.
• Fasting: You will typically need to stop eating or drinking hours before the procedure. Fasting helps ensure your stomach is empty, reducing the risk of problems like vomiting.
• Make arrangements: Depending on the type of bronchoscopy and your individual needs, you may be given sedation or anesthesia. Arrange for a responsible adult to bring you home from the hospital or surgical center. You may need to take time off work or arrange help for childcare, household chores and other tasks during recovery.

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant.

What to expect during a bronchoscopy

How a bronchoscopy is performed may vary depending on your condition and your provider’s practices. 

In general, it follows this process:

• You may be asked to change into a gown and remove any jewelry or other objects. This ensures that you are comfortable during the procedure and allows your provider easy access to the area being looked at.
• You will lie on a bed or table with your head propped up.
• You may be given a sedative medicine through an intravenous (IV) line to help you relax and feel sleepy. 
• A numbing medication or local anesthetic will be sprayed into your throat to numb the area. This helps prevent gagging as the scope is passed down your throat.
• You may be given antibiotics before and after the procedure.
• During the procedure, trained medical professionals will closely monitor your vital signs, such as heart rate, blood pressure and oxygen levels.
• Once sedated, a lubricated bronchoscope will be gently inserted through your nose or mouth and into your airways. You won’t be able to talk or swallow, so saliva will be suctioned from your mouth as needed.
• The camera attached to the bronchoscope sends pictures to a screen so your provider can see inside your lungs. Tools may also be used to take a sample, stop bleeding or perform other procedures.
• When the exam is done, the bronchoscope will be taken out.

The procedure may take 30 minutes to 2 hours, depending on why your provider is performing the procedure.

Recovery from a bronchoscopy

After the procedure, you’ll be taken to a recovery area where you’ll rest until the medicine's effects wear off. You may feel a little groggy or sleepy for a short time. You will need to have someone bring you home after the procedure.

You may experience mild side effects after the procedure, such as a sore throat, coughing or a hoarse voice. These symptoms are usually temporary and should improve within a day or two. Warm water gargles and throat lozenges may help.

Your provider will inform you of specific post-procedure instructions. This may include information on when you can start eating and drinking, any medications you need to take and any activities to avoid. 

Call your provider immediately if you have any of the following:

• Fever and chills
• Coughing up blood
• Severe hoarseness
• Feel dizzy or faint

Call 911 or have someone take you to the nearest emergency department if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

How do I understand my results?

After your bronchoscopy, your health care provider will review what they found during the exam. If they took a tissue sample, the results may take some time to get.

Depending on the results, your provider may schedule a follow-up appointment to discuss the findings, treatment plans or further tests as needed. If you have questions about your results, ask your provider to help you understand.

Expert care 

At Banner Health, we provide compassionate, expert care to support your respiratory health. If you have questions about bronchoscopy or wish to schedule a procedure, contact us today. Your journey to better lung health begins with Banner Health.