Bronchoscopy

A bronchoscopy is a test to look at the inside of the breathing tubes (airways) in your lungs. You might have this test to allow your doctor to:

• look for the cause of your symptoms
• help your doctor see any areas that look abnormal on an x-ray or scans
• take samples of cells

These samples might be a tissue sample called a biopsy. Or your doctor might take some cells by using a small brush or using a liquid to collect them.

To have the test your doctor puts a narrow, flexible tube called a bronchoscope down your windpipe (trachea) and into your airways. You have it put through your mouth or nostril. You have a nose or mouthguard put in first. The tube has a light at the tip and an eye piece so they can see the lining of the airways.

You normally have this as an outpatient or day case procedure in the endoscopy unit. To help you relax you usually have a local anaesthetic with or without some light sedation . But sometimes you might need to have this test under a general anaesthetic . 

Having a bronchoscopy under a general anaesthetic means that the doctor can remove a larger sample of tissue (biopsy). Or they can put a tube (stent) in place to keep the airway open. If you need this a specialist lung doctor does it using a rigid bronchoscope.

Your doctor will explain what sedation you need and why.

The procedure takes about 20 minutes, but can be longer or shorter depending on the number of cell samples they need to take.

What do I need to do to prepare for a bronchoscopy?

You’ll be given written instructions on how to prepare for your bronchoscope. For example, they will ask you not to eat and drink for a few hours before the test.

Take your usual medicines as normal unless your doctor tells you otherwise. If you take warfarin or other blood thinners to thin your blood, you need to stop this before your bronchoscopy. Your doctor will tell you when to stop them.

I'm having a general anaesthetic 

This means you will be asleep and won't feel anything during the test. You can't eat or drink for a few hours beforehand. Check your letter to find out when you need to stop eating and drinking. Contact the department in advance if this is a problem for you, for example, if you have diabetes.

You meet the anaesthetist before your test. They look after you while you have the anaesthetic and while the chest doctor is carrying out your bronchoscopy. The anaesthetist might give you some painkillers to prevent soreness.

What happens on the day?

Before the test

When you arrive at the outpatient department the nurse takes some measurements. This includes your blood pressure, heart and breathing rate, your oxygen level and weight.

You’ll see your doctor who will explain what’s going to happen and ask you to sign a consent form. This is a good time to ask any questions you may have.

You may need to change into a hospital gown, or you might be able to stay in your own clothes.

If you’re having a local anaesthetic with or without a light sedation

The nurse takes you to the test room. You may have the test sitting upright on the procedure couch or lying down. The nurse will explain what position they want you in.

You might have a sedative. This will help you to relax and can make you feel sleepy, but you will be able to answer questions. You have the sedative through a small tube into your vein (cannula).

The doctor will numb your nose and throat using a local anaesthetic. They will either use a spray or a spray and gel. This can make you cough; your eyes may water and you may have a bitter taste in your mouth. 

Once this is working you may feel like you can't swallow but you can. 

The nurse or doctor also places a nose or mouthguard in the area the bronchoscope will travel down.

Attached to one of your fingers is a clip to monitor your heart rate and oxygen levels throughout the test.

If you are having a general anaesthetic 

The nurse will take you to the room and you lie on a couch. To get you to sleep the anaesthetist puts a cannula in one of your arms. You then have the anaesthetic drug through the cannula into your bloodstream.

During the test

Your doctor puts the bronchoscope into your mouth or down a nostril to your airways. This is a bit uncomfortable but it doesn't last long and shouldn’t hurt because you have had the local anaesthetic. You can breathe normally.

Your doctor then looks for anything abnormal and can take tissue samples (biopsies) to test. Or your doctor might take some cells by using a small brush or using a liquid to collect them. They can also take photographs of the inside of your airways.

Your nurse or anaesthetist checks your oxygen levels and heart rate using the clip on your finger.

After the test

Afterwards, you'll feel sleepy. A nurse will monitor you in the recovery area until you are awake enough to leave.

You won’t be able to eat or drink anything until the local anaesthetic wears off. This is because your throat is too numb to swallow safely at first. This usually passes after about an hour.

The nurse will remove the cannula before you are ready to leave.

Going home

You can usually go home the same day. If you take blood thinners your doctor or nurse will tell you when to restart them. This is usually the next day. Someone should collect you from the hospital and stay with you overnight if you have had a sedative or anaesthetic.

You shouldn't drive or drink alcohol for 24 hours after having a sedative or anaesthetic. You also shouldn’t operate heavy machinery or sign any important documents.

You need to take things easy for a day or so. You might have a sore throat for a couple of days.

Are there any risks from having a bronchoscopy?

A bronchoscopy is a safe procedure, but your nurse will tell you who to contact if you have any problems afterwards. Your doctor will make sure the benefits of having a bronchoscopy outweigh these possible risks.

Bleeding

You might see a small amount of blood in your spit after the test. Let your doctor or nurse know if this doesn’t go away or gets worse.

Chest infection

See your GP straight away if your phlegm (sputum) changes colour, you start feeling more breathless or you have a temperature.

Needing extra oxygen

You might need oxygen through a mask for a short time. It is not usually no more than an hour after your bronchoscopy, but this can vary. If you normally have oxygen at home you might need to have more than usual for a little while.

A collapsed lung (pneumothorax)

Air can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain. If this happens, usually the team caring for you will keep an eye on you and it usually goes on its own. Much more rarely your doctor might need to put a tube into the lung to remove the air.

Infection

There is a risk of getting an infection during this test. Tell your doctor if you have any symptoms of an infection. These may include a temperature, feeling cold or shivery, aching muscles, feeling tired and headache.

Getting your results

You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.

Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.

We have more information on tests, treatment and support if you have been diagnosed with cancer.