Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
How the Test is Performed
A bronchoscope is a device used to see the inside of the airways and lungs. The scope can be flexible or rigid. A flexible scope is almost always used. It is a tube less than 1/2-inch wide and about 2 feet long. In rare cases, a rigid bronchoscope is used.
The scope is passed through your mouth or nose through your windpipe (trachea) and into your lungs. Going through the nose is a good way to look at the upper airways. Going through the mouth allows the doctor to use a larger bronchoscope. If a flexible bronchoscope is used, you will probably be awake but sedated. During the procedure:
A numbing drug (anesthetic) will be sprayed in your mouth and throat. If bronchoscopy is done through the nose, numbing jelly will be placed in one nostril.
The scope is gently inserted. It will likely make you cough at first. The coughing will stop as the numbing drug begins to work.
The doctor may send saline solution through the tube. This washes the lungs and allows the doctor to collect samples of lung cells, fluids, and other materials inside the air sacs. This part of the procedure is called a lavage.
Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope to take very small tissue samples (biopsies) from your lungs.
The doctor can also place a stent in the airway or view the lungs with ultrasound during the procedure.
Sometimes ultrasound is used to view the lymph nodes and tissues around the airways.
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 6 to 12 hours before the test
Not to take aspirin, ibuprofen, or other blood-thinning drugs before the procedure. Ask the doctor who will do the 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 patients may need to stay overnight in the hospital.
How the Test will Feel
Local numbing medicine (anesthetic) is used to relax and numb your throat muscles. Until the 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 the windpipe (trachea). 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 given to relax you help with these symptoms and 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 doctor diagnose lung problems. Your doctor will be able to inspect the airways or take a biopsy sample.
Common reasons to perform a bronchoscopy for diagnosis are:
Lung growth, lung cancer, lymph node, atelectasis, or other changes seen on an x-ray or other imaging test
Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.