Bronchoscopy - a simple test that looks inside the lungs with a camera

Have you had a cough for a long time, maybe some blood in your phlegm, or difficulty breathing? After an X-ray or CT scan, did the doctor say that they need to put a small camera inside the lungs to look? That's what we call a bronchoscopy. The name sounds a bit complicated and scary, but it's actually not that scary. Let's take a quick look at what it is, how it's done, and what you need to know.

What is Bronchoscopy?

Simply put, a bronchoscopy is a procedure that helps your doctor see inside your airways and lungs. This is done using a special instrument called a bronchoscope. This is a thin, flexible tube with a camera and light on the end. This tube is inserted through your mouth or nose, passed down your windpipe, and into your lungs, where it can be viewed on a monitor. It's like watching a video of the inside of your lungs.

There are two types of these bronchoscopes.

Why would a doctor recommend this test?

If you suspect that there is something wrong with your lungs, a doctor will recommend this test to find out the exact cause. Imagine if you had something like this:

• Find the cause of symptoms such as persistent cough, coughing up blood, and difficulty breathing .
• If you suspect something unusual in your lungs, perhaps a cancerous tumor, on an X-ray or CT scan , get it confirmed.
• If something is blocked in the airway (for example, if a small child swallows something like a toy), remove it.
• To determine the exact cause of an infection or inflammation in the lungs, take a mucus sample from there.
• The most important thing is that a small piece of tissue (biopsy) can be taken from a suspicious area and sent for testing . This is very important to know for sure whether it is cancer or not.
• If the airway is blocked, a small tube is inserted to keep it open again. We call this a stent .

How should I prepare for this test?

Preparing for this is not that difficult. Your doctor will give you all the advice you need. But in general, keep these things in mind.

1. Fasting: You will be instructed not to eat or drink anything for a few hours before the test, usually 6-8 hours . This is very important. If you have food in your stomach during the test, it could come back up and enter your lungs. This can be dangerous.

2. Tell your doctor about your medications: If you are taking any blood thinners or diabetes medication, you should definitely tell your doctor about it. He or she may ask you to stop taking the medication for a few days. Also tell your doctor about any vitamins or herbal remedies you are taking.

3. Avoid driving: Since you will be given a sedative for this test, you will not be able to drive after the test. Therefore, it is essential to have someone drive you home .

What happens during the test?

This test is usually done in a hospital or operating room. Most of the time, you can go home the same day. Let's take a step-by-step look at what happens.

• First, you will be given a sedative through an IV cannula to help you relax and feel drowsy. You will gradually begin to feel lighter and sleepier.
• Then , a numbing spray is applied to your mouth and throat. This will help reduce any discomfort, coughing, and nausea that you may feel when the camera is inserted. You may feel a little tight in your throat and have difficulty swallowing. This is normal, don't worry.
• After you are very sleepy, the doctor will carefully insert the bronchoscope through your mouth or nose and pass it down your windpipe into your lungs.
• You won't feel any pain at this time. Your breathing, heart rate, and oxygen levels are all monitored by machines. So you are completely safe.
• To remove saliva and mucus that accumulates in the mouth during the examination, a small tube can be used to suction them.
• Once the test is complete, the priest will remove the tube. The entire process takes about 30 to 90 minutes .

Will I be fully anesthetized for this?

Most of the time, you will be given a sedative (medication that makes you very sleepy). You may not remember the test. However, if a rigid bronchoscope is used, or if something complicated is being done, you may need to be put under general anesthesia. Your doctor will explain this in advance.

What happens after the test?

After the test, you will be kept in a recovery room for a few hours before being sent home. The medical staff will take care of you until the effects of the sleeping medication wear off, you are fully conscious, and you are not having any difficulty swallowing. Sometimes a chest X-ray may be taken to make sure there are no problems with your lungs.

Expect these things after you get home:

• Sore throat: You may have a sore throat, a slight cough, and hoarseness for about a day. Don't worry about it. You can get relief by taking cough drops that are good for your throat.
• Food and Drink: Do not eat or drink anything until the sore throat is completely gone (which can take an hour or more) . Doing so can cause the food or drink to be aspirated into the lungs. Once the sore throat is gone, drink some water first, then start with soft foods like porridge and yogurt.
• Rest: Rest well that day. You can resume your normal activities the next day.

You will be told before you leave the hospital when the results will be available and when you should see your doctor again. If a biopsy was taken, it may take a few days, or even a week, for the results to arrive.

Risk factors and symptoms to report to your doctor immediately

First of all, this is a very safe test . Complications are very rare. But it's good to be aware of them.

• A small hole in the airway.
• A minor infection or swelling of the vocal cords.
• A condition similar to a collapsed lung. In medical terms, we call this a pneumothorax .

Although things like this happen very rarely, the medical team is prepared to deal with any such situation.

However, if you experience any of the following symptoms after returning home, it could be a sign of an infection or other problem. If this happens, go to the hospital's Emergency Department (ETU) or call your doctor immediately.

Bronchoscopy, lung examination, cough, shortness of breath, lung cancer, respiratory disease, biopsy, Sinhala medical article