What is a Bronchoscopy?

A Bronchoscopy is a test which allows the endoscopist to look directly into your large airways (trachea and bronchi). These are the main tubes that carry air into your lungs. A fibre-optic bronchoscope, thin as a pencil, flexible telescope is passed through your nose or throat, into your wind pipe (trachea), and down into your bronchi. The bronchoscopy usually takes about 20-30 minutes.

What else may be done during the procedure?

The endoscopist may take one or more samples (biopsies) of parts of the inside lining of the airways (depending on why the test is done and what they see). This is painless. The samples are sent to the laboratory for testing and to be looked under the microscope.
Sometimes bronchial lavage is done. This is a procedure where some fluid is squirted into a section of the lung and then suctioned back. The fluid is then examined in the laboratory to look for abnormal cells and other particles that may be present in certain diseases.

Preparation

To prevent vomiting or aspiration, the stomach must be empty. You will therefore be asked not to have anything to eat or drink for at least six hours before the test. When you come to the department, a doctor or nurse will explain the test to you and will usually ask you to sign a consent form. This is to ensure that you understand the test and its implications. Please tell the doctor or nurse if you have had any allergies or bad reactions to drugs or other tests. They will also want to know about any previous endoscopy you have had. If you have any worries or questions at this stage, don’t be afraid to ask, the staff will want you to be as relaxed as possible for the test and will not mind answering your queries.

During the procedure

In the examination room you will be made comfortable on a bed, resting on your back. A nurse will stay with you throughout the test. You will have a local anaesthetic in a form of spray on the back of your throat to numb it and an injection into your arm to make you feel sleepy and relaxed. If going through the mouth, to keep it slightly open, a plastic mouthpiece will be put gently between your teeth. When the endoscopist passes the bronchoscope into your airway, you should expect some coughing but you will still be able to breathe at any time. If you get a lot of saliva in your mouth, the nurse will clear it using a sucker. When the examination is finished, the bronchoscope is removed quickly and easily.

After the procedure

You will be left to rest in the unit for at least thirty minutes. As you had your throat numbed by a spray, you will have to wait until your swallowing reflex is back to normal – this usually takes no more than an hour. After this, you can eat and drink normally. The back of your throat may feel sore for the rest of the day.

Going home

It is essential that a responsible adult comes to pick you up and remains with you up until 12 hours. Once home, it is important to rest quietly for the remainder of the day. Sedation lasts longer than you think, so if you have been given an injection during the examination you should not: drive; operate machinery; drink alcohol; or sign legal documentation for 24 hours. The effects of the test and injection should have worn off by the next day, when most patients are able to resume normal activities.

When will I know the results?

In most cases the endoscopist will be able to tell you the results as soon as you are awake, and you will receive a copy of the report to take home. However, if a sample (biopsy) has been taken for examination, the results may take a few weeks. It is a good idea to have someone with you when you speak to the nurse after the test since people often find they forget everything that has been said to them and many do not recollect having the test at all after sedation. Further details of the results and any necessary treatment can be discussed with your general practitioner or hospital specialist – whoever recommended you to have the test.

What to expect after Bronchoscopy

After a bronchoscopy there are minimal side effects, but it is sensible that you are aware of the following:
• Food and drink
Alcohol in combination with any sedation you may have received is more likely to make you much more sleepy that usual. Due to the local anaesthetic used in your throat, you should not eat or drink until normal sensation returns, usually within an hour of the procedure. Normal food can be taken after the examination, though you may prefer light meals on the day of the examination.

• Pain
A mildly sore throat and nose is no cause for concern and should resolve within 48 hours. If you are troubled by more than this, please consult your own GP or contact the Endoscopy Department.

• Activities
If you have been given sedation during the procedure it will make you less alert than usual and you should therefore not drive or make any decisions for the rest of the day. You may resume normal activities on the day after the examination.

• Medications
You may be asked not to take anti-coagulation medication but will be able to resume normal medications immediately after the bronchoscopy. Please ask if you are not sure that a medication is safe.

• Things to report to your doctor:

• Severe pain or vomiting
• Temperature greater than 38 degrees
• Redness, tenderness and swelling at the site of the intravenous injection that persists

If you have any worries please do not hesitate to either contact the Endoscopy Department, your own GP or go to your nearest Accident & Emergency Department (taking a copy of the endoscopy report with you).