What Happens During a Bronchoscopy?
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Medically reviewed by Brian Bezack, DO
A bronchoscopy is a medical procedure that allows healthcare providers to look inside your airways and lungs using a bronchoscope—a thin and flexible tube with a small camera. A pulmonologist (a medical doctor specializing in diagnosing and treating lung diseases) will use a bronchoscopy to visualize your airways, identify signs of lung disease, and collect tissue samples to diagnose and treat some lung conditions.
Purpose
If your healthcare provider recommends a bronchoscopy, it's likely because you have symptoms of a lung condition and they want to understand what inside your lungs may be causing your symptoms. The primary purposes of this medical procedure are to help your provider diagnose and treat various lung diseases.
Diagnosis
A bronchoscopy allows for a clear visual examination of your airways, which includes the trachea (windpipe), bronchi (large tubes that connect the trachea to the lungs), and bronchioles (smaller tubes in the lungs). Healthcare providers use bronchoscopies to:
Determine the cause of respiratory symptoms (e.g., difficulty breathing or chronic cough)
Identify abnormalities in the airways, such as blockages and tumors
Collect tissue samples (biopsies) of the airways, lungs, or nearby lymph nodes
Look for signs of inflammation or infection
By examining your airways and collecting tissue samples during the procedure, healthcare providers can diagnose lung diseases, such as bacterial infections, lung cancer, and interstitial lung disease.
Treatment
A bronchoscopy also serves as a tool for treating certain lung conditions or problems with the airways. Healthcare providers may use a bronchoscopy to:
Eliminate foreign objects that are obstructing the airways
Control bleeding in the airways
Widen a narrowed or constricted airway with stents
Remove mucus plugs or fluid from your airways
Administer cancer treatment directly to the affected tissues
Types of Bronchoscopy
There are two main types of bronchoscopes that healthcare providers use during the procedure:
Flexible bronchoscopy: The most common bronchoscopy procedure, a flexible bronchoscope uses a thin, flexible tube less than 0.5 inches wide and two feet long. Equipped with a light and camera, the bronchoscope transmits the camera's view onto a screen so healthcare providers can see and take photos of your airways.
Rigid bronchoscopy: This procedure uses a straight, inflexible, hollow metal tube (available in several sizes) equipped with a light and camera, allowing healthcare providers to visualize your airways. This is not a common procedure and is generally only reserved for removing large foreign objects obstructing the airways, treating blood clots, or placing stents to open the airways.
How Does It Work?
A bronchoscopy is an outpatient procedure, meaning you won't require an overnight hospital stay and can go home shortly after the procedure. If you or a loved one are receiving a bronchoscopy, knowing how to prepare and what to expect can make this process easier for you.
Before the Procedure
When you arrive for your bronchoscopy, your healthcare provider will explain the procedure and potential risks, benefits, and complications before asking you to sign a consent form. This is a good time to address any questions or concerns you may have about the procedure.
Your provider will review your medical history and medications and place an intravenous (IV) line into your arm. They will also set up monitors on your body that continuously measure your heart rate, blood pressure, and oxygen level throughout the procedure. You will also wear an oxygen mask or nasal cannula (tubing) that will deliver extra oxygen to your lungs.
During the Procedure
During a bronchoscopy, you will lie comfortably on an examination table or hospital bed with your head slightly elevated. You will receive sedation or numbing medication (e.g., spray) in your mouth and nose and medicines through your IV line to help you relax and not experience pain or discomfort during the test.
Your pulmonologist will gently insert the bronchoscope through your mouth or nose and navigate it down your windpipe into your lungs' airways. You may cough or gag as the tube moves through your windpipe or feel like you cannot breathe for a brief moment, but this is temporary and not a risk.
Then, your provider will use the camera on the bronchoscope to broadcast images of your airways on a screen and perform any necessary procedures, such as collecting tissue samples or removing blockages. A bronchoscopy procedure takes about 30 to 45 minutes to complete, though some are longer depending on the reason for the bronchoscopy.
After the Procedure
Once the procedure is complete, your healthcare team will monitor you closely in a recovery area to ensure you don't experience complications. You may have some mouth and throat numbness from the anesthesia or sedation for a couple of hours—and it's important not to eat or drink until the numbness wears off.
The effects of the sedative medications may continue even when the throat numbness wears off, so you should arrange a ride home with a family member or friend. Some medical centers will not discharge people to a cab or ridesharing service (e.g., Uber or Lyft), so talk to your healthcare provider about available options if arranging transportation home is a hardship.
Keep in mind: it's common to experience a sore throat, cough, and hoarseness for a day or two after the procedure. Otherwise, you should be able to drink and eat normally once the sedation wears off. However, it's a good idea to verify any discharge instructions with your healthcare provider before going home.
Risks and Precautions
A bronchoscopy is a safe procedure that comes with minimal risks. However, as with any medical procedure, there are some potential side effects or complications to be aware of, such as:
Discomfort or cough when the provider inserts the bronchoscope into your mouth or nose
Minor bleeding in your nose or mouth, especially if a biopsy was collected during the procedure
Reduced oxygen levels due to the blockage of some airflow during the procedure
Infection
Collapsed lung (known as pneumothorax), which is rare but can occur if air leaks from the lungs into the space between the lungs and the chest wall
People with certain medical conditions may not be suitable candidates for a bronchoscopy. Your provider may be extra cautious about recommending a bronchoscopy if you have or had:
Uncontrolled bleeding or blood clotting disorders
Recent heart attack
Untreatable heart arrhythmias (irregular heartbeat)
Heart disease
How To Prepare for Bronchoscopy
Planning and taking proactive steps to prepare for a bronchoscopy can help ease anxiety and ensure a smooth experience during the procedure. Here's what you can expect:
Location: Most bronchoscopies occur in an outpatient setting, either in a hospital's outpatient procedures department or specialized clinic.
Attire: Wear comfortable clothing to the hospital, as you may need to change into a hospital gown for the procedure.
Food and drink: Your healthcare provider will ask you to avoid eating and drinking for 8 to 12 hours before the procedure.
Medications: Discuss all your medications with your healthcare provider beforehand. They may ask you to temporarily stop taking certain medications, such as blood thinners, aspirin, or ibuprofen before the test.
Items to bring: Bring your government-issued identification (e.g., driver's license), insurance card, and a list of your current medications. If you have prior imaging tests related to your lungs, such as chest X-rays, bringing those along may also be helpful.
Emotional support: Bringing a loved one to your appointment can sometimes help reduce test anxiety. They can wait in the recovery room and give you a ride home after the procedure.
Cost and insurance: Most insurance plans cover bronchoscopies. Contact your insurance provider beforehand to discuss your coverage and any potential out-of-pocket expenses (e.g., copay or deductible).
Results
Your healthcare provider may discuss the initial bronchoscopy findings with you before you go home right after the procedure ends. Sedation medications can make it challenging to remember everything you discuss, so it can help to have a family member or friend in the room with you or a healthcare advocate to record the details.
In many cases, healthcare providers recommend a follow-up appointment to review the full report and discuss biopsy results if they collected tissue samples during the procedure. Generally, it can take two to four days for biopsy results and a week or longer for the full bronchoscopy report.
Interpreting Your Results
When you have a follow-up appointment with your healthcare provider, they will discuss the results of your test and answer any questions you have. If your results were normal, this means that no abnormalities, such as cancerous cells, fluids, or blockages, were found.
If you receive an abnormal bronchoscopy result, this may mean you have a lung disease, such as:
Narrowed or blocked airways
Cancer in the lung, airways, or surrounding space
Lung damage from an autoimmune disorder (e.g., rheumatoid arthritis)
Allergic-type reaction to a chemical or lung irritant
A bacterial, fungal, viral, or parasitic lung infection
If your test results are inconclusive (meaning, they cannot confirm nor deny a diagnosis), your provider will likely order additional diagnostic tests to confirm a diagnosis. If you receive a diagnosis from the original bronchoscopy, however, your healthcare team will work with you to discuss next steps and develop a treatment plan for your condition.
A Quick Review
A bronchoscopy is a procedure that allows a pulmonologist to examine the inside of your airways and lungs to diagnose and treat lung diseases. The test uses a small and thin tube attached to a camera to visualize your airways and check for signs of lung conditions like blocked airways and lung cancer.
You can expect test results to be back within a week. A normal result means you're in the clear, but an abnormal result may mean you have a lung condition. If you receive a diagnosis, worry not, as your healthcare team will find a treatment plan that is most suitable for your needs.
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