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St. Stephens Hospital

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Bronchoscopy

Overview

A bronchoscopy is a procedure that lets a pulmonologist examine the windpipe (trachea) and the major airways inside the lungs. A thin flexible scope with a camera is passed through the nose or mouth, with the patient under sedation. It is one of the most useful tests in lung medicine. Where chest X-rays and CT scans show that something is there, bronchoscopy lets the doctor see it directly — and take samples, fluid, or biopsies to make a precise diagnosis.

What is this test?

A thin, flexible tube (about the thickness of a pencil) with a high-definition camera is passed through the nose (or mouth) and down through the vocal cords into the airways. The doctor sees the lining of the trachea and bronchi on a screen.
Small instruments through the scope allow the doctor to wash the airways for samples (bronchoalveolar lavage or BAL), take biopsies, or remove obstructions in the same session.

Why your doctor may order it

  • Persistent or unexplained cough
  • Coughing up blood (haemoptysis)
  • Investigating an unexplained mass, shadow, or nodule seen on chest X-ray or CT
  • Diagnosing infections — particularly tuberculosis or fungal infections — when sputum tests are inconclusive
  • Assessing airway narrowing or obstruction
  • Lung cancer diagnosis and staging
  • Investigating interstitial lung disease
  • Removing inhaled foreign bodies

How long does it take?

The bronchoscopy itself takes 20 to 45 minutes. With sedation recovery and observation, plan for 3 to 4 hours at the hospital.

How to prepare

  • Fast for 6 to 8 hours before the procedure.
  • Tell us about all medications, especially blood thinners. Some may need to be stopped a few days before.
  • Tell us about heart disease, breathing problems, allergies (especially to local anaesthetic), and sleep apnoea.
  • Continue your inhalers as usual on the day of the procedure unless told otherwise.
  • Arrange for someone to accompany you — you cannot drive for 24 hours.
  • Bring your prescription, ID, all recent imaging (X-ray, CT), and any previous lung reports.

What to expect during the test

You change into a gown and a cannula is placed. You will be connected to monitors for oxygen, heart rate, and blood pressure. Local anaesthetic is sprayed into the nose and throat to numb them. The sensation is unusual — your throat feels strange — but not painful. Light sedation is then given through the cannula.
The scope is gently passed through the nose or mouth, through the vocal cords, and into the airways. You can breathe normally around the scope at all times. Oxygen is given through a nasal prong throughout.
If samples are needed, the doctor will wash the area or take small biopsies. These are usually painless. The whole procedure is typically well-tolerated.

After the test

  • You rest in recovery for 1 to 2 hours while sedation wears off and your gag reflex returns.
  • Your throat may feel sore for a day or two — lozenges and warm liquids help. Mild blood-streaked sputum for 24 hours is normal, especially after a biopsy.
  • Do not eat or drink until your gag reflex has fully returned (usually 2 hours).
  • Do not drive, operate machinery, sign legal documents, or drink alcohol for 24 hours.
  • Watch for warning signs and contact us immediately if you have: heavy or fresh bleeding, severe shortness of breath, chest pain, or fever.
  • Bronchoscopy report: same day. Biopsies: 3 to 7 days. Cultures (for TB and other infections): up to 8 weeks.

Do's and Don'ts

  • Fast strictly as instructed.
  • Bring all recent X-rays and CT scans with you.
  • Arrange someone to take you home.
  • Rest your voice and throat for the rest of the day.
  • Drink soothing warm liquids (not too hot) once your throat is ready.
  • Don't eat or drink during the fasting period.
  • Don't continue blood thinners unless your doctor has confirmed it is safe.
  • Don't smoke for at least 24 hours before and several days after — it irritates the airways and slows healing.
  • Don't drive or make important decisions for 24 hours.
  • Don't ignore worsening breathlessness, heavy bleeding, or fever — get checked.

Understanding your results

The bronchoscopy report describes the appearance of the airways, with photos of any abnormality. Common findings include normal airways, inflammation, narrowing, secretions, or visible growths.
Samples taken during the procedure are sent for microbiology (looking for infection, TB, fungi) and histopathology (looking at tissue under a microscope). Results take from 3 days to several weeks, depending on the tests. Your pulmonologist will discuss the full picture once results are in.

Frequently asked questions

You will be lightly sedated. Most people are drowsy and remember little. You will not be fully unconscious — being awake enough to breathe normally is important for the procedure.

You may feel a sense of pressure or fullness, but the local anaesthetic blocks the gag and cough reflex. Sedation makes the experience comfortable for most.

Bronchoscopy is generally safe. Mild bleeding, sore throat, and brief drop in oxygen are common and self-limiting. Serious complications (significant bleeding, pneumothorax, severe sedation reaction) are uncommon. We will discuss specific risks with you before the procedure.

CT shows what is there. Bronchoscopy lets the doctor look directly and take samples to find out exactly what it is. A specific diagnosis allows specific treatment.

Yes — particularly in patients whose sputum tests are negative but where TB is suspected. Samples from the lung often give the diagnosis when other tests have not.

Test Duration
20 to 45 minutes (the procedure itself)
Type

Flexible scope passed through the nose or mouth into the airways

  • Appointment By appointment
  • Fasting 6 to 8 hours
  • Sedation Yes — IV sedation with local anaesthetic to the airways
  • Report time Same day for the report; 3 to 10 days for biopsy and cultures
Contact

Emergency Call Now Information