What happens inside your lungs? Let's talk about bronchoscopy!

Do you sometimes have a persistent cough, difficulty breathing, or a little blood in your phlegm when you cough? At such a time, when you go to see a doctor, if he tells you to "do a bronchoscopy", you can feel a little scared, right? So, what is this bronchoscopy? Why is it done? Does it hurt when it is done? Today, we will discuss the answers to many questions that you have in your mind in this article. There is no reason to be afraid, this is not as difficult as most people think.

What is a bronchoscopy in simple terms?

Simply put, a bronchoscopy is a procedure in which a thin tube with a small camera (bronchoscope) is passed into your windpipe (trachea) and lungs. It's like an endoscopy, which looks inside your stomach, but this one is for your lungs. The camera and light at the end of this tube allow the doctor to see the inside of your airways clearly. This can help diagnose, assess, and sometimes treat certain lung conditions.

Just like when a water pipe in our house gets clogged, we insert a small wire and look at it. Doctors use this device to see what's going on inside the lungs.

There are two types of bronchoscope tubes:

• Flexible Bronchoscope: This is the most commonly used. It is flexible, like a rubber tube, so it can be easily passed down the airway. It is used to keep the airway open, take a tissue sample (biopsy), and suction out things like mucus.
• Rigid Bronchoscope: This is a thick, rigid tube. It is used when there is a large blockage in the airway, or for more complex procedures such as placing a stent, treating tumors, or stopping bleeding.

What does a bronchoscopy find?

There are several reasons why a doctor might ask you to have this test. Let's take a look at what they are:

• Diagnose a lung disease: Find the cause of your symptoms, such as a persistent cough, coughing up blood, and difficulty breathing.
• After an X-ray or CT scan: This is done to investigate further if something unusual is seen on your X-ray or CT scan, such as signs of cancer.
• Airway obstructions: Assess for obstructions and narrowings in the airways and remove or treat them.
• Detect infections or inflammation: Find out exactly what causes infections or inflammatory conditions in the lungs.
• Take a sample: Take a sample of mucus or tissue (biopsy) and send it for lab tests. This will help determine exactly what the disease is.
• Insert a stent: Sometimes this method is used to insert a small tube (stent) to keep the airway open if it is narrowed.

Imagine, our aunt Kamala's cough didn't subside for months. She even coughed up a little blood. When she did an X-ray, there was a small spot on her lungs. Then the doctor said to do a bronchoscopy, that's when we could find out exactly what was wrong.

How should I prepare for this?

Your doctor or nurse will give you specific instructions on how to prepare before you have this test. But in general, here are some things you should do:

• Fasting: It is best not to eat or drink anything for a few hours before the test. Usually about 6 to 8 hours.
• Stopping certain medications: You may be asked to stop taking certain medications, such as blood thinners (e.g., aspirin, warfarin), or diabetes medications, for a few days. It is important to tell your doctor about all medications, vitamins, and herbal remedies you are taking.
• Someone to drive you home: You will be given a sedative to make you sleepy during this test, so you will not be able to drive after the test. Therefore, you will need to bring someone to drive you home.

Do I need a CT scan before a bronchoscopy?

Unless it's an emergency, your doctor will often order a CT scan (Computed Tomography scan) of your lungs before a bronchoscopy. A CT scan can help your doctor determine if a bronchoscopy is necessary, or if there are any areas that need to be examined.

What happens during a bronchoscopy?

This test is usually done by a pulmonologist in a hospital or operating room. Most of the time, it is done on an outpatient basis. This means that you can go home the same day after the test.

You will be given medication to make you sleepy and comfortable. If you are having a rigid bronchoscopy or a biopsy, you may be given general anesthesia. This means you will be so sleepy that you will not feel anything. Talk to your doctor about what type of anesthesia you will be given.

Bronchoscopy is most often performed like this:

1. Saline : A small tube (IV line) is inserted into a vein in your arm and medicine is given through it to make you feel relaxed and sleepy.

2. Lying on a bed: Lying on a bed with the head slightly elevated.

3. Spray to numb:A numbing spray is applied to your mouth (and possibly your nose) and throat. This will reduce the discomfort you feel when you insert the tube.

4. Inserting the bronchoscope: After you are sedated and drowsy, the doctor will slowly insert the bronchoscope through your nose or mouth, or through a tube inserted at that time if you are anesthetized, into your windpipe and then into your lungs.

5. Removing saliva: Since you can't swallow, the saliva that collects in your mouth can be removed with a small tube.

6. Removing the bronchoscope: When the examination is complete, the doctor slowly removes the tube.

7. Under observation: Medical staff will take care of you until you regain consciousness.

Do you fall completely asleep while doing this?

You will often feel very sleepy, and may even fall asleep. This depends on the type of bronchoscopy you are having and what the doctor is looking for. Most people do this under general anesthesia. Some minor tests can be done with just a local anesthetic.

How long does a bronchoscopy take?

It usually takes about 30 to 90 minutes . The exact time it takes depends on the reason the doctor is doing it.

What happens after the test?

As mentioned earlier, this is an outpatient procedure, so you don't have to stay in the hospital. You can go home within a few hours after the test.

The medical team will observe you for a while to see if you are breathing and swallowing properly. The doctor may also decide to do a chest X-ray after the exam to see if there are any problems.

Your throat will be numb for about an hour. You may have a sore throat, cough, and hoarseness for the next 24 hours. Cough drops can be used to relieve a sore throat. Most people can return to normal activities the next day. Your doctor will tell you if you need to limit your activities.

The medical team will let you know when you can expect the test results and when you should return to see the doctor.

How long does it take to recover?

You will need to stay in the hospital recovery room for at least 45 minutes, possibly longer, until you are no longer drowsy and your vital signs (such as breathing and blood pressure) return to normal. During this time, the medical staff will monitor you closely to see if you have any unusual side effects after the test.

Can I eat and drink after the test?

Do not eat or drink anything until the numbness in your throat has completely gone (which can take up to an hour). Once the numbness has gone, drink some water first, then start with bland foods like porridge and yogurt.If you eat or drink too quickly, the food and drink can go into your lungs (aspirate) or you may choke.

What are the possible complications of bronchoscopy?

Bronchoscopy is a very safe procedure, but there are very rare risks, such as:

• A hole in the airway.
• Damage or inflammation of the vocal cords.
• Pneumothorax.

Most often, doctors use a flexible bronchoscope because it can be easily guided through the airways and can reach small areas of the lungs. However, in some cases, a rigid bronchoscope is needed.

Before having this test, talk to your doctor about the risks and whether you are at high risk for complications.

How long does it take for bronchoscopy results to come back?

Ask your medical team when you will get the results. If a biopsy was taken during the test, the results should be available within a week. Depending on the type of test, the results may be available sooner or later.

Your doctor will use these results to decide what your next treatment steps will be. This can vary from person to person, depending on what was found during the bronchoscopy.

When should I contact my doctor?

After the test, you should call your doctor right away if you experience any of these symptoms. These could be signs of an infection, a collapsed lung, or another problem:

• Chest pain.
• Difficulty breathing.
• Persistent fever.
• Persistent cough or coughing up blood.
• Symptoms of pneumonia (e.g. high fever, chest pain, runny nose).

Finally, remember this (Take-Home Message)

Bronchoscopy is nothing to be afraid of. It is a safe test that helps to find problems in your lungs and airways. Sometimes it can even be used to treat them. It is done in an outpatient setting, where a small tube is passed into your lungs. If your doctor tells you to have this test, he or she will tell you more about how to prepare for it. If you have any questions, don't hesitate to ask your doctor. Your health is the most important thing!

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