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Everything You Need to Know About a Bronchoscopy

If you have shown signs of lung problems or potential lung disease, you may be looking at a bronchoscopy. But what is a bronchoscopy and when is it indicated? Learning what this procedure is for, when it is used and what it can tell you about your lungs and airways can help you feel better prepared.

What Is a Bronchoscopy?

Bronchoscopy is a procedure that allows your doctor to insert a bronchoscope to look at your lungs, your airways or even your lymph nodes to diagnose lung problems, airway problems and lung disease. Bronchoscopy can also be used to take lung samples via saline, called lavage, as well as being used for biopsies, placing a stent in your airway, getting an ultrasound of your lungs or removing mucus or other obstructions. Additionally, bronchoscopy can also be used as an intervention treatment for bleeding in the lungs, collapsed lungs or stricture (narrowing) of the airways.[1][2]

Depending on the type of procedure you need, your doctor may use a flexible bronchoscope or a rigid bronchoscope. You may be given medication before the procedure to help you relax, or you may be put under general anesthesia. You will also be given a numbing drug, which is typically sprayed into your mouth and your throat, to help numb the areas through which the bronchoscope will travel. If the procedure is done through your nose, numbing jelly will be used.2

When Is Bronchoscopy Indicated?

Typically, a bronchoscopy is ordered to identify a problem in the lungs or the airways. If you have a persistent cough or respiratory infection without an obvious cause, or if your doctor sees something else of concern on a chest X-ray, they are likely to order a bronchoscopy to see if they can diagnose the problem. They may also order a bronchoscope for narrowing in your airways, vocal cord paralysis or infections like tuberculosis, pneumonia and fungal or parasitic lung infections.[3]

Bronchoscopy may be indicated for certain procedures and for administering some treatments. If your doctor needs a biopsy, to clear your airways, to drain an abscess or even to provide laser therapy or radiation for bronchial tumors, bronchoscopy is often used for these procedures.

Bronchoscopy and COPD

Bronchoscopy is often used as a diagnostic tool for COPD. Because the doctor can use it to take a close look at your airways and lungs, and get a biopsy of your lungs or airways, a bronchoscopy can give your doctor a lot of information about the current state of your respiratory system. With flexible bronchoscopy, your doctor can check for infection, bronchus carcinoma and more. Because this procedure is safe for COPD patients, it is an excellent way to gather information that can help your doctors make the right treatment plan for you.[4]

Beyond diagnostic use, bronchoscopy can be used as an intervention for patients with COPD. Currently, some therapies administered via bronchoscopy are under development, with results that look very promising. Treatments for patients with emphysema, in particular, appear to have benefits, including lung volume reduction treatments, endobronchial coils, endobronchial valves and sealants and vapor therapy.[5]

Complications and Risks Associated With Bronchoscopy

Complications resulting from bronchoscopy are unusual and typically minor. There are fewer risks associated with the flexible bronchoscope, as it is less likely to damage tissue.

The risks involved with bronchoscopy are:3

  • Bleeding
  • Bronchial perforation
  • Infection
  • Irritation of the airways and resulting bronchospasms
  • Irritation of the vocal cords and larynx
  • Collapse of the lung due to air entering the pleural space, or the space between the lung covering

Ultimately, bronchoscopy is an effective tool for most patients in order to diagnose and treat problems in the lungs and airways.

When Bronchoscopy is Not an Option

Some patients may be unable to get bronchoscopy because they have:3

  • Low oxygen levels
  • Pulmonary hypertension, or high blood pressure in the blood vessels in their lungs
  • Severe coughing or gagging reflex
  • Severe narrowing in or blocking of the trachea

Some patients with hypercapnia, or high carbon dioxide levels in their blood, or patients with severe shortness of breath may still be able to have a bronchoscopy procedure with adequate preparation. They may require oxygen therapy before the procedure so that oxygen can be sent directly to the lungs while the bronchoscopy takes place. This helps preserve oxygen levels and prevents excess carbon dioxide buildup.

For most patients, a bronchoscopy is a low-risk procedure that can provide a significant amount of information about the respiratory system. While it is more invasive than some other diagnostic tests, its low risk factor makes it well suited for gathering important information about lung and airway health.

Frequently Asked Questions: Bronchoscopy

Can a bronchoscopy detect COPD?

Because bronchoscopy can be used to look inside the airways and the lungs, it can be used to detect COPD. It is often not the first test used, as it is more invasive than spirometry and other tests. However, because your doctor is able to see the tissue in your lungs and airways, and take samples when necessary, bronchoscopy can be a highly effective diagnostic tool for detecting and diagnosing COPD.

What to expect after a bronchoscopy?

After a bronchoscopy, your mouth and throat will remain numb for several hours, and you will remain in the medical center to be monitored for several hours. Until your numbness wears off, you will not be able to eat or drink to protect you from aspirating anything. Once the numbness wears off, you will be able to drink first then eat soft foods. You may experience a sore throat, hoarse voice, cough or aches in your neck and chest muscles. Your doctor may prescribe gargling with warm water or sucking on lozenges to ease discomfort.3 Follow your doctor’s instructions carefully to ensure you do not eat or drink before your system is capable of reacting normally.

Will a bronchoscopy change my oxygen needs?

During the procedure, it is possible that you could develop a low blood oxygen level as a result of sedation or the scope blocking part of your airway. In this case, your health care team will provide you with extra oxygen. Patients who may be prone to low oxygen levels may need additional oxygen therapy before the procedure. The results of the procedure could indicate that you are in need of daily supplemental oxygen therapy. Your doctor will review your oxygen needs with you before your procedure, as well as any results that indicate the need for additional oxygen therapy.

Sources Cited

[1] “Bronchoscopy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 May 2019, www.mayoclinic.org/tests-procedures/bronchoscopy/about/pac-20384746.
[2] “Bronchoscopy: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 26 Feb. 2021, medlineplus.gov/ency/article/003857.htm.
[3] “Bronchoscopy.” Johns Hopkins Medicine, Johns Hopkins Medicine, 7 Mar. 2021, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bronchoscopy.

[4] Grendelmeier, Peter, et al. CHEST Journal, CHEST Organization, 1 Oct. 2015, journal.chestnet.org/article/S0012-3692(16)36646-6/fulltext.

[5] Garner, Justin, and Samuel Kemp. “Interventional Bronchoscopy for COPD .” Clinical Pulmonary Medicine, Wolters Kluwer Health, Inc., Mar. 2017, journals.lww.com/clinpulm/Abstract/2017/03000/Interventional_Bronchoscopy_for_COPD.6.aspx.

Additional Sources

“Bronchoscopy.” American Lung Association, American Lung Association, 5 Mar. 2020, www.lung.org/lung-health-diseases/lung-procedures-and-tests/bronchoscopy.

“COPD Symptoms.” American Lung Association, American Lung Association, 5 Mar. 2021, www.lung.org/lung-health-diseases/lung-disease-lookup/copd/symptoms-diagnosis.

Make, Barry J, and Irina Petrache. “COPD: Diagnosis.” National Jewish Health, National Jewish Health, 1 Sept. 2016, www.nationaljewish.org/conditions/copd-chronic-obstructive-pulmonary-disease/overview/diagnosis.


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