Bronchoscopy

Published by Bupa's Health Information Team, July 2011.

This factsheet is for people who are having a bronchoscopy, or who would like information about it.

Bronchoscopy is a procedure that allows a doctor to examine the airways using a bronchoscope.

You will meet the doctor carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About bronchoscopy

Bronchoscopy is done using a bronchoscope. This is a flexible tube with a telescopic light and camera at the end, which allows your doctor to see down your airways and into your lungs. Doctors often use flexible bronchoscopy to diagnose a lung problem. Your doctor can take samples of cells from your airways using a washing technique. He or she can also remove a small piece of tissue so that it can be examined (this is called a biopsy).

Bronchoscopy can also be done with a rigid bronchoscope. This is less common and is done under general anaesthetic. This means you will be asleep during the procedure. Doctors may use a rigid bronchoscope if there is bleeding in your lungs, or to remove objects blocking your airway, such as a piece of food.

What are the alternatives?

X-rays and CT scans be used to look at your lungs, but bronchoscopy lets your doctor take samples of tissue within your airways and look at them in more detail.

Preparing for bronchoscopy

Flexible bronchoscopy is routinely done as an outpatient or day-case procedure. This means you have the procedure and go home the same day. It's usually done under local anaesthesia with sedation. This completely blocks pain from the nose and throat area and you will stay awake during the procedure.

Your doctor will explain how to prepare for your bronchoscopy. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest infection, which can slow your recovery.

You will be asked not to eat or drink for at least four hours before the procedure.

At the hospital your nurse will check your heart rate and blood pressure. You may also have a blood test, chest X-ray and breathing test, although this isn’t usually required.

Your doctor will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during a bronchoscopy

You may have a sedative injection to help you relax. This will make you feel drowsy. Then you will lie on the couch and your doctor will spray the inside of your nose and throat with an anaesthetic to numb the area.

Your doctor will pass the bronchoscope through your nose or mouth and into the airways of your lungs. This may feel uncomfortable but it won't last long. Your doctor will give you more local anaesthetic to reduce coughing. If you find yourself coughing, you should try to relax and take slow, shallow breaths through your mouth. He or she will examine your airways by looking at images sent though a camera attached to a video screen. Your doctor may take a sample such as a biopsy, brushings and washings of any abnormal areas.

Afterwards, your doctor will remove the bronchoscope. This doesn’t usually hurt. The procedure should take between 10 and 20 minutes.

What to expect afterwards

After a local anaesthetic, it may take several hours before the feeling comes back fully into your throat. You will need to rest until the effects of the local anaesthetic and sedation have passed.

A nurse will monitor you while you recover. You may have a chest X-ray to check for complications. Don't eat or drink anything for two hours after the procedure because your throat will be numb. It can be normal for you to have a small amount of blood in your mouth after the procedure.

Sometimes your doctor will be able to discuss your results straight away. It’s a good idea to have someone with you because the sedative can make you forget what the doctor says. If samples were taken, your doctor will tell you when the results will be ready, which is generally in about a week.

You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home, and you should try to have a friend or relative stay with you for the first 24 hours.

Recovering from a bronchoscopy

Sedation temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor's advice.

You may have a sore throat after the procedure. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You shouldn't have any problems after bronchoscopy. Contact your GP, or go to your local accident and emergency department if you:

• have chest pain
• have difficulty breathing
• cough up a large amount of blood (more than a tablespoon)
• have a high temperature

What are the risks?

As with every procedure, there are some risks associated with a bronchoscopy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

You may have a sore throat after the procedure but this should only last a few days. You may also cough up a little blood. 

Complications

Complications are when problems occur during or after the procedure.

Complications of flexible bronchoscopy are uncommon but can include: 

• excessive bleeding
• a reaction to the sedative or local anaesthesia
• a collapsed lung
• infection

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.