Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
How the test is performed
A bronchoscope is a device used to see the inside of the airways and lungs. Although it can be flexible or rigid, a flexible bronchoscope is almost always used. The flexible bronchoscope is a tube less than 1/2 inch wide and about 2 feet long. Rarely, a rigid bronchoscope is used.
The scope is passed through your mouth or nose, through your windpipe (trachea), and then into your lungs. Going through the nose is a good way to look at the upper airways. The mouth method allows the doctor to use a larger bronchoscope.
If a flexible bronchoscope is used, you will probably be awake.
The doctor will spray a numbing drug (anesthetic) in your mouth and throat. If the bronchoscopy is done through the nose, numbing jelly will be placed on one nostril.
Inserting the bronchoscope will make you cough at first. The coughing will stop as the numbing drug begins to work. When the area feels thick, it is numb enough.
Once you are numb, the tube will be inserted into the lungs.
The doctor may send saline solution through the tube. This washes the lungs and allows the doctor to collect samples of lung cells, fluids, and other materials inside the air sacs. This part of the procedure is called a lavage.
Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope and used to take very small tissue samples (biopsies) from your lungs.
The doctor can also place a stent in the airway or view the lungs with ultrasound during a bronchoscopy.
A rigid bronchoscope requires general anesthesia. You will be asleep.
How to prepare for the test
Do not eat or drink anything 6 - 12 hours before the test. Your doctor may also want you to avoid any aspirin, ibuprofen, or other blood-thinning drugs before the procedure.
You may be sleepy after the test, so you should arrange for transportation to and from the hospital.
Many people want to rest the following day, so make arrangements for work, child care, or other obligations. Usually, the test is done as an outpatient procedure, and you will go home the same day. Some patients may need to stay overnight in the hospital.
How the test will feel
Local numbing medicine (anesthesia) is used to relax and numb your throat muscles. Until the anesthetic begins to work, you may feel fluid running down the back of your throat and have the need to cough or gag.
Once the medicine takes effect, you may feel pressure or mild tugging as the tube moves through the windpipe (trachea). Although many people feel like they might suffocate when the tube is in the throat, there is NO risk of this happening. The medicines given to relax you help with these symptoms and will help you forget most of the procedure.
When the anesthetic wears off, your throat may be scratchy for several days. After the test, the cough reflex will return in 1 - 2 hours. You will not be allowed to eat or drink until your cough reflex returns.
Why the test is performed
You may have a bronchoscopy to help your doctor diagnose lung problems. Your doctor will be able to inspect the airways or take a biopsy sample.
Common reasons to perform a bronchoscopy for diagnosis are:
Lung growth, lymph node, atelectasis, or other changes seen on an x-ray or other imaging test
Kupeli E, Karnac D, Mehta Ac. Flexible bronchoscopy. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 22.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, Pa. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.