Bronchoscopy

What is bronchoscopy?

Bronchoscopy is an examination of your windpipe and air passages by means of a flexible telescope. A bronchoscopy is a test that your doctor will suggest when there is a need to have a look in the air passages or take samples from the lung when testing for certain diseases.

Unlike X-rays which take “photographs” of the lung, bronchoscopy lets the doctor see inside the windpipe and airways, areas not clearly shown on X-rays.

When is bronchoscopy necessary?

Your doctor will usually request a bronchoscopy when they suspect something is wrong with your airways or lungs.

A persistent cough, the coughing of blood, or an abnormality on a chest X-ray are the most common reasons. The results will help your doctor determine what is wrong and how to help you in the most effective way.

Preparation for your bronchoscopy

You will be required to not eat or drink for 6 hours before the bronchoscopy. If you normally take any tablets, discuss with your doctor before the test which tablets you can take and when to take them.

You may need to stop some tablets like aspirin or blood thinners (e.g. warfarin) but check with your doctor. If you have diabetes and take insulin, special arrangements may need to be made.

If you receive sedation, arrange for a responsible adult to accompany you home and stay with you overnight. Do not drive yourself or travel alone on public transport.

What happens during your bronchoscopy?

Usually, the bronchoscopy is done with the help of some sedative drugs. The test usually takes about 20 minutes. When you arrive for your test, you may be given local anaesthetic spray or gargle for your nose and throat. This numbs the nose and throat, reducing any discomfort during the bronchoscopy, but it often makes you cough a little to begin with.

You may also be given a sedative injection, but will not be completely “sent to sleep” as you might for a major operation. Sometimes, instead of sedation, you may be advised to have a full general anaesthetic.

The bronchoscope itself is a flexible tube with several channels. One sends light into the lung, another is connected to a camera to see inside the lung and there is a channel to put local anaesthetic into and for taking samples. The tube is passed gently through a nostril or the mouth and guided into the windpipe at the back of the throat.

When taking samples, an X-ray machine is sometimes used to place the bronchoscope in the correct area of the lung.

Usually, salty water is washed into the airway and sucked back to retrieve germs or cells. A small brush like a bottle brush and needles or forceps may also be used to collect specimens of the lung or lymph glands in the chest. Sometimes, other more specialised tests are undertaken which will be explained by your doctor.

After your bronchoscopy

The numbness of the throat from the local anaesthetic usually takes 1–2 hours to wear off, during which time you should not have anything to eat or drink as it may go down the “wrong way”. You will be kept under nursing supervision during this time.

Sometimes, after special biopsies of the lung tissue, you may be advised to have an X-ray. If you are being tested for tuberculosis, you may be required to wear a mask or stay in the recovery room with a nurse after the procedure.

Because of the sedative you receive, you must check with your doctor about how long you should wait before driving, using machinery, using public transport, going back to work, signing legal documents etc.

A slight fever and cough are not uncommon for 1–2 days. If you get any more serious side-effects, please let your doctor know. If biopsies were taken during the procedure, it is common to notice a slight red colour in your sputum for a day or two. If you cough up more than a small amount of blood (more than about a 20-cent-coin-sized amount at a time), contact your doctor or the hospital straight away; if the bleeding is heavy or you are short of breath, call 000.