Bronchoscopy

How to Prepare for the Test

Follow instructions on how to prepare for the test. You will likely be told:

• Not to eat or drink anything for 6 to 12 hours before your test.
• Not to take aspirin, ibuprofen, or other blood-thinning drugs before your procedure. Ask the provider who will do your bronchoscopy when to stop taking these drugs.
• Arrange for a ride to and from the hospital.
• Arrange for help with work, child care, or other tasks, as you will likely need to rest the next day.

Usually, the test is done as an outpatient procedure and you will go home the same day. Some people may need to stay overnight in the hospital.

How the Test will Feel

Local anesthetic is used to relax and numb your throat muscles. Until this medicine begins to work, you may feel fluid running down the back of your throat. This may cause you to cough or gag.

Once the medicine takes effect, you may feel pressure or mild tugging as the tube moves through your windpipe. Although you may feel like you are not able to breathe when the tube is in your throat, there is no risk of this happening. The medicines you receive to relax will help with these symptoms. You will likely forget most of the procedure.

When the anesthetic wears off, your throat may be scratchy for several days. After the test, your ability to cough (cough reflex) will return in 1 to 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 provider diagnose lung problems. Your provider will be able to inspect your airways or take a biopsy sample.

Common reasons to do a bronchoscopy for diagnosis are:

• An imaging test showed abnormal changes of your lung, such as a growth or tumor, changes or scarring of lung tissue, or collapse of one area of your lung.
• To biopsy lymph nodes near your lungs.
• To see why you are coughing up blood.
• To explain shortness of breath or low oxygen levels.
• To see if there is a foreign object in your airway.
• You have a cough that has lasted more than 3 months without any clear cause.
• You have an infection in your lungs and major airways (bronchi) that cannot be diagnosed any other way or need a certain type of diagnosis.
• You inhaled a toxic gas or chemical.
• To see if a lung rejection after a lung transplant is occurring.

You may also have a bronchoscopy to treat a lung or airway problem. For example, it may be done to:

• Remove fluid or mucus plugs from your airways
• Remove a foreign object from your airways
• Widen (dilate) an airway that is blocked or narrowed
• Drain an abscess
• Treat cancer using a number of different techniques
• Wash out an airway

Normal Results

Normal results mean normal cells and fluids are found. No foreign substances or blockages are seen.

What Abnormal Results Mean

Many disorders can be diagnosed with bronchoscopy, including:

• Infections from bacteria, viruses, fungi, parasites, or tuberculosis.
• Lung damage related to allergic-type reactions.
• Lung disorders in which the deep lung tissues become inflamed due to the immune system response, and then damaged. For example, changes from sarcoidosis or rheumatoid arthritis may be found.
• Lung cancer, or cancer in the area between the lungs.
• Narrowing (stenosis) of the trachea or bronchi.
• Acute rejection after a lung transplant.

Risks

Main risks of bronchoscopy are:

• Bleeding from biopsy sites
• Infection

There is also a small risk of:

• Abnormal heart rhythms
• Breathing difficulties
• Fever
• Heart attack, in people with existing heart disease
• Low blood oxygen
• Collapsed lung
• Sore throat

Risks when general anesthesia is used include:

• Muscle pain
• Change in blood pressure
• Slower heart rate
• Nausea and vomiting

References

Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 83.

Kupeli E, Feller-Kopman D, Mehta AC. Diagnostic bronchoscopy. In: Broaddus VC, Mason RJ, Broaddus VC, Martin TR Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 22.

Scanlon PD. Respiratory function: mechanisms and testing. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 85.