Bronchoscopy is the procedure performed by a pulmonologist to view the respiratory airways and lungs. It is a diagnostic method that uses a thin, tube-like instrument known as the bronchoscope fitted with a lens and light. This procedure helps diagnose lung diseases and infections. Apart from detecting the causes of breathing difficulties, a doctor performs bronchoscopy to:
The airways (trachea and bronchi) and the lungs
How is Bronchoscopy Performed?
There are three types of bronchoscopic procedures—flexible, rigid, and endobronchial ultrasound. In the first type, doctors use a bendable tube or bronchoscope that reaches your bronchioles. In the second type, doctors use a wide, straight bronchoscope to remove blockages from airways, place stents, or collect mucus samples. The third type combines bronchoscopy and ultrasound imaging.
The method to conduct bronchoscopy using different bronchoscopes is the same. At first, you will receive a sedative intravenously to help you relax but remain conscious. In some cases, doctors may decide to give general anaesthesia. Since it is an endoscopic procedure, an anaesthetic will be sprayed in your throat and nostrils to numb those areas. The doctor will then insert the bronchoscope down your throat till it reaches your airways and lungs. This part may be slightly uncomfortable initially, but your body will get used to it.
The camera fitted at the bronchoscope's tip guides the doctor visually while performing the procedure. The doctor will then examine your lungs and airways and collect samples if required. After completing the bronchoscopy, the doctor will gently remove the bronchoscope. The procedure takes about 45 minutes.
Bronchoscopy Procedure Type
Preparation for Bronchoscopy
Here is how to prepare yourself before going in for the procedure.
Diet: Do not consume food or drinks at least eight hours before the procedure.
Medication: Your doctor may advise you to avoid taking medications, such as blood thinners (like aspirin) and ibuprofen, for a week before the procedure. If you regularly consume any other medicines, consult your doctor to ask whether you may continue taking them.
Clothing and accessories: The clinic or hospital will provide you with a gown to wear during the procedure. Remove jewellery, spectacles, contact lenses, dentures, hearing aids, and other accessories.
Consent form: Before signing the consent form that details the benefits and possible risks of the procedure, clarify all your doubts.
Other arrangements: Since bronchoscopy involves the administration of anaesthetics whose effects may take a few hours to wear off, ask a family member or friend to drive you home.
Follow up After Bronchoscopy
After the procedure, the healthcare staff will monitor you for a few hours by checking your vital signs, such as heart rate, oxygen saturation levels, and blood pressure. Some clinics conduct a chest X-ray to check the condition of the lungs. They will also schedule a follow-up appointment to discuss the bronchoscopy results with your doctor.
You won't be able to eat or drink anything immediately until the numbing effects of the anaesthetics wear off. It is a safety measure to prevent food particles from unknowingly entering your lungs and airways. You can start with soft foods and small sips of liquid once the numbness subsides. It is common to experience a hoarse feeling in the throat. Relieve it by slowly sucking on cough lozenges or drops. On reaching home, relax for the rest of the day.
For the first 24 hours after the procedure, avoid alcohol, driving, handling heavy machinery, exerting yourself physically, and making crucial decisions that involve legalities and signatures. Refrain from taking tranquilisers or sleeping pills.
Risks Factors of Bronchoscopy
Bronchoscopy is a relatively simple and painless procedure. However, like any other medical process, it may present the following risks or side effects:
Persistent fever: A fever of more than 100.4 degrees Fahrenheit is common after a bronchoscopy. It may be a systemic inflammatory response to endoscopy.
Abnormal oxygen levels: The oxygen pressure may decrease by over 10-20 mm Hg after the procedure, leading to oxygen desaturation.
Bleeding: It usually happens when the doctor performs a biopsy along with the bronchoscopy. This complication is relatively rare and subsides without medication.
Collapsed lungs: An accidental airway rupture/injury or lung puncture during the procedure can cause air accumulation around the lungs. This complication eventually leads to a lung collapse requiring immediate medical intervention.
Arrhythmia: A rapid heart rate and increased blood pressure are common side effects of this procedure.
Infection: Although rare, bacterial and viral infections may occur, leading to pneumonia, lung abscess, and pus formation after a bronchoscopy.
Recovery After Bronchoscopy
Most individuals recover fully and regain their usual functionality within 24 hours after the procedure. Please get in touch with your healthcare provider if you experience fever for more than 24 hours, inflammation of the intravenous site, coughing of blood, chest tightness, and breathing difficulties.
It may take a couple of days for the hoarseness in your throat to subside. Also, the feeling of dryness in your mouth may persist. Lozenges and salt water gargling should help you feel better and recover faster. Drink plenty of water to avoid dehydration and sleep whenever you feel tired to ensure quick healing. Remember to discuss with your doctor when you can restart your regular medications and daily activities.