Bronchoscopy preparation

Overview

A bronchoscopy is a medical procedure where a doctor uses a thin, flexible tube with a tiny camera (called a bronchoscope) to look inside your airways and lungs. It helps find the cause of symptoms like a long-lasting cough, breathing problems, or an infection that won’t go away. During the test, the doctor can also take small samples of tissue (biopsy) or remove an object that may be stuck in the airway.

Yes, bronchoscopy is a common procedure performed in hospitals and specialist clinics all over the world.

Bronchoscopy is used for people of all ages who have symptoms or conditions affecting the lungs or airways, such as persistent cough, unexplained breathlessness, or abnormal findings on a chest X-ray or CT scan.

Symptoms

Common symptoms

• Persistent cough that lasts more than three weeks
• Shortness of breath or wheezing
• Coughing up blood or blood-stained phlegm
• Recurrent chest infections or pneumonia
• Unexplained chest pain

Symptoms in children

• Persistent cough that does not improve with usual treatments
• Noisy breathing or a high-pitched sound when breathing in (stridor)
• Frequent chest infections or pneumonia
• Unexplained breathing difficulties

Symptoms in older adults

• Shortness of breath that gets worse over time
• Long-term cough with or without phlegm
• Unexplained weight loss along with breathing symptoms
• Coughing up blood

Causes

Main causes

• Lung infections that do not improve with antibiotics (like pneumonia or tuberculosis)
• Inflammation in the airways (bronchitis) that becomes chronic
• A foreign object (like a peanut or small toy) stuck in the airway
• Suspected lung cancer or other growths in the airways
• Scarring or narrowing of the airways (stenosis)

Risk factors

• Smoking or long-term exposure to tobacco smoke
• Weakened immune system due to illness or medicines
• Long-term inflammatory lung conditions (such as asthma or COPD)
• Breathing in harmful substances at work (like dust, chemicals, or fumes)
• Family history of lung cancer

When to see a doctor

See a doctor urgently if:

• If you are coughing up blood, even a small amount
• If you have sudden or worsening shortness of breath
• If you have new chest pain that does not go away

Book a routine appointment if:

• If you have a persistent cough that lasts more than three weeks
• If you have repeated chest infections
• If you are concerned about a lung condition and want to discuss it with your healthcare provider

Diagnosis

Bronchoscopy is the main test used to directly see the inside of your airways. Your doctor may also use other tests beforehand to decide if a bronchoscopy is needed. These tests can include a chest X-ray, a CT scan of the chest, breathing tests (spirometry), and blood tests.

Tests that may be done

• Chest X-ray – a simple image of your lungs to look for shadows or fluid
• CT scan – a more detailed scan that creates cross-sectional images of your chest
• Breathing test (spirometry) – measuring how well your lungs work
• Blood tests – to check for infection or inflammation
• Bronchoscopy – the doctor inserts a thin tube into your airways to see inside, take tissue samples, or remove objects

What to expect at your appointment

Before the bronchoscopy, you will be asked to not eat or drink for about 6 to 8 hours. On the day of the procedure, a nurse will prepare you and give you a sedative or anesthetic to make you sleepy and comfortable. The doctor will gently pass the bronchoscope through your mouth or nose into your airways. You may feel some pressure or a gagging sensation, but you should not feel pain. After the test, you will be monitored until you wake up. You may have a mild sore throat or cough for a day or two. Your doctor will discuss the results with you, often after laboratory tests on any samples are completed (which can take a few days to a week).

Treatment

Treatment after a bronchoscopy depends on what the doctor finds. The procedure itself is diagnostic, so the results will guide further care. If a lung infection is found, you may be given antibiotics. If inflammation is present, medicines to reduce inflammation may be recommended. If an object is stuck in the airway, it can often be removed during the bronchoscopy using tiny instruments.

Self-care at home

• Rest for the remainder of the day after the procedure
• Drink plenty of water to help soothe your throat
• Avoid smoking or exposure to smoke for at least 24 hours
• Avoid driving, operating machinery, or making important decisions until the sedative wears off completely (usually 24 hours)

Medical treatments

If the bronchoscopy shows a condition that needs treatment, your doctor will discuss options. These may include prescription medicines (like antibiotics for infection or inhalers for airway inflammation), and in some cases, oxygen therapy or procedures to widen narrowed airways. Specific treatments depend on your individual diagnosis and health status, and your healthcare team will tailor a plan for you.

When is surgery considered?

If a serious condition like lung cancer is found, surgery may be considered. However, many lung problems can be managed without surgery, and your doctor will discuss all options with you, including the risks and benefits of surgery if it might help.

Living with this condition

Most people recover quickly from a bronchoscopy. You can usually return to your normal routine the next day. If a lung condition is diagnosed, your healthcare provider will give you a plan to manage it. This might include taking medicines, doing breathing exercises, and attending regular check-ups.

Lifestyle tips

• If you smoke, try to quit – smoking harms your lungs and can make conditions worse.
• Avoid exposure to second-hand smoke, dust, chemicals, and other irritants.
• Get vaccinated for flu and pneumonia if recommended by your doctor.
• Stay active with gentle exercise, like walking, to keep your lungs healthy.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains supports overall health. If you have a lung condition, aim for moderate exercise such as walking or cycling, as your body allows. Your doctor may refer you to a pulmonary rehabilitation programme if needed.

Mental health and emotional wellbeing

Waiting for test results or living with a lung condition can cause anxiety or stress. It is normal to feel worried. Talk to your healthcare team about your concerns – they can offer support and connect you with a counsellor if needed.

Prevention

You cannot always prevent the need for a bronchoscopy, as some lung problems are due to infection, genetics, or unknown causes. However, you can reduce your risk of lung disease by not smoking, avoiding lung irritants, and getting vaccinated for infections like influenza and pneumonia.

Vaccines

Vaccines for the flu and pneumonia are recommended, especially for people at higher risk. Talk to your doctor or pharmacist about which vaccines are right for you.

Screening programmes

If you have a high risk of lung cancer (for example, due to smoking or family history), your doctor may suggest regular low-dose CT scans. Screening is not recommended for everyone, so check with your healthcare provider.

Complications

If left untreated

• Delayed diagnosis of a serious condition like lung cancer or a severe infection
• Worsening of breathing problems if an airway blockage is not removed
• Spread of infection to other parts of the lung or bloodstream

Long-term outlook

Most people who have a bronchoscopy find it helpful for diagnosis and treatment. The outlook depends on the underlying condition. Many lung problems can be treated effectively, especially when caught early. Your healthcare team will work with you to get the best possible results.

Find support

International organisations

• American Thoracic Society – Patient Information ↗
• European Lung Foundation ↗

Local organisations

• British Lung Foundation ↗ · UK
• Asthma + Lung UK ↗ · UK

Helplines

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