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Pulmonology | by CMRI
A bronchoscopy is a procedure that allows doctors to examine your lungs and airways, including the bronchi which are the main air pathways in your lungs.
To perform a bronchoscopy, doctors insert a bronchoscope through the nose or mouth and down the throat to reach the lungs. A bronchoscope is a thin tube made of fiber-optic material either flexible or rigid, containing a light and camera at the end. Based on the findings, doctors diagnose infections, tumors, or diseases in the lungs.
Doctors normally use a flexible bronchoscope to perform the procedure. But in rare cases involving excessive bleeding or a blocked airway, doctors can use a rigid bronchoscope to perform the procedure.
Nonetheless, the procedure is usually quick and painless, requires minimal preparation, and has a fast recovery time.
A bronchoscopy can be used to diagnose:
· A lung disease
· An infection
· A chronic cough
· A tumor
In addition, a bronchoscopy is typically used to procure mucus or tissue samples, and remove foreign objects, mucus plugs, or fluid causing an airway blockage. For instance, if you are experiencing breathing difficulties, a doctor may refer you for a bronchoscopy to identify the cause.
A bronchoscopy is also used as a treatment tool – for lung diseases such as cancer, collapsed lung, or abnormally narrowed airways. And to identify abnormalities in chest X-rays or CT scans that show evidence of a lung condition.
Also, during a bronchoscopy procedure, doctors can either insert a bronchoscope into the airways or take a biopsy wherein a small tissue sample is extracted for testing.
Preparing for a bronchoscopy usually involves food and medication restrictions for a specified period. Your doctor will inform you about the necessary precautions you should take owing to your current medication use.
You have to avoid foods and drinks for at least 6-12 hours before the bronchoscopy procedure. Your doctor will also advise you against certain medications like:
· Warfarin
· Ibuprofen
· Aspirin
· Clopidogrel
· Blood thinners
You will likely be given sedative medicines via IVs or a local anesthetic spray to help you relax. Make sure to arrange a ride or someone to take you back home after the procedure. Because of the sedatives as you will be unable to drive.
In addition, have someone look after you for the entire day as sedatives may take longer to wear off.
Before the procedure, doctors spray a numbing drug or sedative into the mouth or throat. But if the bronchoscope is inserted through the nose, a numbing jelly is placed in the nostrils. Many people are given anesthesia to help them relax.
Once people start to relax from sedatives, doctors gently insert the bronchoscope into the bronchi. This usually makes people cough at first but subsides as the numbing drug takes effect. As doctors move the bronchoscope around, you can feel a tugging or pressing sensation.
The next part of the procedure is called a lavage or bronchial washing. Doctors send a saline solution through the tube to wash the lungs. Lavage is also used to collect samples of lung cells, microbes, fluids, and other substances inside the air sacs. These samples are examined later under a microscope.
Additionally, tiny brushes, needles, or forceps are sometimes passed through the bronchoscope to take small tissue samples (biopsies) from the lungs. Doctors can also insert a stent in your airways and perform an ultrasound. This helps doctors to have a clearer view of the lymph nodes and tissues around the airways.
Once the procedure finishes, doctors remove the bronchoscope. A bronchoscopy typically lasts about 30-60 minutes based on your lung condition and the number of examinations. And people can return home on the same day.
Bronchoscopy is usually safe for most people. Nonetheless, there are certain risks involved, although uncommon and minor. Complications may arise because of the sedative used or the procedure itself.
Risks may include:
· Breathing troubles
· Minor bleeding, if a biopsy was done
· Fever
· Infection
· Pneumonia
· Abnormal heartbeat
· Low blood oxygen levels during the procedure
After the procedure, if you experience symptoms such as fever, breathing difficulties, or if you are coughing up blood – contact your doctor immediately as these symptoms indicate infection.
In rare cases, bronchoscopy can also cause a heart attack or lung to collapse which is known as pneumothorax. The chances of pneumothorax are usually increased when doctors use a rigid bronchoscope to perform the procedure.
· Muscle pain
· Nausea
· Vomiting
· A slow heart rate
· Change in blood pressure
Recovery time
Recovery from bronchoscopy is fairly fast. You have to stay at the hospital for a couple of hours and let the sedative wear off once the procedure is over. Doctors usually monitor your breathing and blood pressure during recovery time.
The numbness in your throat will subside within two hours. Following this, you can safely consume any food and drink. However, your throat will be sore for a couple of days.
