Risks and benefits of bronchoscopy

Overview

Bronchoscopy is a medical procedure where a doctor looks inside your airways (windpipe and lungs) using a thin, flexible tube with a camera on the end called a bronchoscope. It helps diagnose and sometimes treat lung problems.

Yes, bronchoscopy is a common procedure performed in hospitals for people with lung symptoms or suspected lung disease.

It is used for adults and occasionally children who have unexplained lung problems, such as persistent cough, coughing up blood, or abnormal chest X-rays.

Symptoms

Common symptoms

• Persistent cough that doesn't go away
• Coughing up blood or blood-stained mucus
• Shortness of breath or wheezing
• Chest pain or tightness
• Frequent lung infections or pneumonia

Symptoms in children

• Chronic cough
• Noisy breathing or stridor (high-pitched sound when breathing in)
• Suspected aspiration (breathing food or liquid into the lungs)
• Recurring pneumonia

Symptoms in older adults

• Persistent cough with or without blood
• Unexplained weight loss and fatigue
• Shortness of breath that gets worse
• Lung masses or abnormalities seen on scans

Causes

Main causes

• To diagnose the cause of a chronic cough or coughing up blood
• To investigate abnormal findings on chest X-ray or CT scan (like a mass or shadow)
• To take samples of lung tissue or cells to check for infection, inflammation, or cancer
• To remove blockages like mucus plugs, foreign objects, or tumours
• To treat conditions like a collapsed lung (pneumothorax) or to stop bleeding in the airway

Risk factors

• Smoking or long-term exposure to tobacco smoke
• History of lung disease such as chronic obstructive pulmonary disease (COPD) or asthma
• Weakened immune system due to illness or medication
• Blood clotting disorders or taking blood thinners (like warfarin or aspirin)
• Advanced age or other serious health conditions

When to see a doctor

See a doctor urgently if:

• If you cough up blood or have sudden chest pain
• If you have unexplained difficulty breathing
• If you have a high fever with chills after the procedure

Book a routine appointment if:

• If you have a persistent cough lasting more than 3 weeks
• If you have recurrent pneumonia or lung infections
• If you have weight loss, fatigue, or appetite loss along with lung symptoms

Diagnosis

Bronchoscopy itself is often used as a diagnostic tool. Your doctor may recommend it after other tests like a chest X-ray or CT scan show something unusual. The procedure allows direct visual inspection of your airways and collection of samples.

Tests that may be done

• Chest X-ray or CT scan before the procedure
• Blood tests (including clotting check)
• Lung function tests (spirometry) in some cases
• Bronchoalveolar lavage (washing a small area of lung to collect cells)
• Biopsy (taking a tiny tissue sample) for analysis

What to expect at your appointment

You will be asked not to eat or drink for several hours before the procedure. A numbing spray is applied to your throat, and you may be given a sedative to help you relax. The bronchoscope is passed through your mouth or nose into your windpipe. The procedure takes about 30 minutes to an hour. You will be monitored for a few hours afterward until the sedation wears off.

Treatment

Bronchoscopy can be used both to diagnose and to treat certain lung conditions. The benefits include obtaining tissue for diagnosis, removing blockages, and stopping bleeding. The risks are generally low but include bleeding, infection, or a small chance of a collapsed lung. Your doctor will discuss these with you.

Self-care at home

• Rest for the rest of the day after the procedure
• Drink cool, soft fluids to soothe your throat
• Avoid hot drinks until the numbness wears off (risk of burns)
• Don't drive, operate machinery, or make important decisions for 24 hours if you had sedation

Medical treatments

Depending on the findings, your doctor may recommend medications such as antibiotics for infection, inhalers for airway diseases, or treatments for the underlying condition. If a tumour or growth is found, further procedures like laser therapy, stent placement, or surgery might be discussed.

When is surgery considered?

Bronchoscopy is usually a minimally invasive alternative to open surgery. If a larger amount of tissue is needed or the problem is deep in the lungs, surgery (like a thoracotomy or video-assisted thoracoscopic surgery - VATS) may be recommended after bronchoscopy results.

Living with this condition

After bronchoscopy, most people return to normal activities the next day. You might have a mild sore throat or cough for a day or two. Follow your doctor's advice regarding any medications or follow-up appointments.

Lifestyle tips

• If you smoke, seek help to quit smoking – it's the best thing for your lung health
• Keep regular check-ups with your GP or lung specialist
• Practice good hand hygiene to reduce infection risk

Diet and exercise

No special diet is needed after bronchoscopy. Eat normally once your throat feels comfortable. Gentle exercise like walking is fine after a day. Avoid heavy lifting or strenuous activity for 48 hours if you had a biopsy.

Mental health and emotional wellbeing

Waiting for results from a biopsy can be stressful. It's normal to feel anxious or worried. Talk to your doctor or a counsellor if these feelings become overwhelming. Remember that many causes are treatable or manageable.

Prevention

Bronchoscopy itself cannot be prevented if your doctor recommends it – it's a necessary procedure. However, some underlying lung problems can be prevented by not smoking, avoiding lung irritants, and getting vaccinated against flu and pneumonia.

Vaccines

Ask your doctor about flu and pneumonia vaccines. They can help prevent lung infections that sometimes lead to the need for bronchoscopy.

Screening programmes

Routine screening for lung cancer is not recommended for everyone. Some high-risk groups (e.g., smokers over a certain age) may be offered low-dose CT scans. Talk to your doctor if you're concerned.

Complications

If left untreated

• If a serious lung condition is not diagnosed, it can worsen over time
• Untreated infection could spread and become more severe
• A blocked airway can cause breathing difficulty and lower oxygen levels

Long-term outlook

For most people, bronchoscopy is a safe and well-tolerated procedure that provides valuable information for diagnosis and treatment. Serious complications are rare. The benefits of getting a clear diagnosis or treatment often far outweigh the small risks. Your healthcare team will take all necessary precautions to keep you safe.

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