What is Bronchoscopy?
Bronchoscopy is a procedure to examine the lungs and airways using an instrument called a bronchoscope.
The device is a thin tube that can be inserted through the nose or mouth, through the throat, and into the lungs.
This procedure can only be performed by a lung specialist (pulmonologist).
A person may need this examination if they have a persistent cough, infection, or other condition that cannot be detected through imaging tests or other tests.
If necessary, the doctor can take a tissue sample from a suspicious area in the airway.
This sample will then be sent to a laboratory for further examination.
Purpose of Bronchoscopy
The main purpose of bronchoscopy is to detect the cause of lung problems.
This procedure can also help the doctor to:
- Identifying the cause of blockage in the lungs or respiratory tract.
- Detecting the cause of lung infections that doctors cannot find through other examinations.
- Find out the origin of lung infection symptoms, such as shortness of breath, persistent cough, and low oxygen levels.
- Perform a biopsy, or take a tissue sample from the lungs, if there are potential symptoms of lung cancer.
- Confirming imaging test results that show abnormal conditions in the lungs.
- Monitoring for signs of incompatibility after undergoing a lung transplant procedure.
- Removes foreign particles that block the respiratory tract.
- Control bleeding that occurs in the lungs and respiratory tract.
Benefits of Bronchoscopy
There are several benefits of a bronchoscopy examination, including the following:
1. Check for abnormal areas in the lungs
If the doctor finds any abnormalities in the lungs, they can use a bronchoscope to see them more clearly.
Through bronchoscopy, doctors can also perform a biopsy, aka take a sample of the abnormal tissue.
The doctor will then examine the sample in the laboratory.
2. See the condition of the lymph nodes near the lungs
You can have a bronchoscopy as part of an endobronchial ultrasonography (EBUS).
This examination is to look at the lymph nodes and other structures in the area between the lungs.
During the procedure, the bronchoscope will be equipped with a microphone-like instrument called a transducer at the end.
The bronchoscope will then be inserted into the airway and can be directed in various directions to view nearby lymph nodes and other structures.
The transducer then emits sound waves that produce an image on the computer screen.
If a suspicious area is seen, such as an enlarged lymph node, the doctor will usually perform a biopsy.
3. Treating lung problems
Bronchoscopy can help treat blocked airways or certain other types of lung problems.
For example, a doctor may attach a tiny laser to the tip of a bronchoscope to burn away the part of the tumor that is blocking the airway.
Doctors may also insert a rigid tube called a stent to open the airway.
4. Early detection of lung cancer
One of the main benefits of bronchoscopy is its ability to detect lung cancer at an early stage.
Through this procedure, the doctor can see directly into the airway and identify any suspicious tumor growths or lesions.
By detecting lung cancer early, the patient’s recovery rate can increase due to faster and more appropriate treatment.
5. Removal of secretions and mucus
Bronchoscopy allows the doctor to clear the airways of excess mucus, blood, or secretions.
This cleansing is important in treating symptoms such as excessive coughing, shortness of breath, or difficulty breathing caused by airway obstruction.
By clearing the airways, patients can experience improved breathing and reduce the risk of further respiratory infections.
Indications for Bronchoscopy
Indications for bronchoscopy will be determined by the doctor based on the following criteria:
- Bronchial tumor or cancer.
- Blockage of the airway (obstruction).
- Areas of narrowing in the airways (strictures).
- Inflammation and infections such as tuberculosis (TB), pneumonia, and fungal infections of the lungs.
- Interstitial lung disease.
- There are spots on the lungs.
- Vocal cord paralysis.
- Persistent cough.
- Coughing up blood.
Bronchoscopy Warning
Bronchoscopy warnings are performed to minimize side effects.
So, before undergoing the procedure, there are things that the doctor needs to know about the patient, as well as the person who will undergo the bronchoscopy.
What are they?
- Bronchoscopy is not done by just any doctor. The doctor will suggest this examination if a chest x-ray cannot detect the disease while the patient is experiencing intense coughing and symptoms of infection.
- The doctor will consider the patient’s medical history before deciding which procedure is most appropriate. Patients with more serious heart or lung problems may require extra monitoring during a bronchoscopy.
- People with conditions such as severe narrowing of the lower airway/trachea, pulmonary hypertension, severe cough, and low blood oxygen levels are not recommended to undergo this procedure. The doctor will recommend other types of tests.
- This medical procedure can be anxiety-provoking, talking to your doctor can help address concerns before the procedure is performed.
- Taking certain medications can cause unwanted interactions during the procedure. That’s why tell your doctor what types of medications you’ve taken in the recent past.
- Sore throat when the procedure is complete is a common condition and will improve with time.
- Complications can occur during this procedure. However, when your doctor recommends this procedure, it means that he or she has considered it best for your condition.
The following are the steps before a bronchoscopy procedure:
Before Bronchoscopy Procedure
- Tell your doctor if you are taking blood thinners. Usually, the doctor will recommend stopping taking the drug.
- Do not eat or drink anything (fast) 6-12 hours before the procedure.
- You must remove all accessories, including glasses, contact lenses, hearing aids before performing a bronchoscopy.
- Don’t forget to invite a companion to accompany you and take you home after the bronchoscopy procedure is performed.
Bronchoscopy Procedure
During a bronchoscopy procedure, here are several steps that the doctor and medical team will carry out:
- You will be asked to sit or lie on a patient’s bed. Next, the nurse will attach a device connected to a monitor to track your heart rate, blood pressure, and oxygen levels during the procedure.
- The doctor will start giving you a sedative to help relax your body. You may feel sleepy, but you will still be awake and able to answer the doctor’s questions during the procedure.
- Afterward, anesthesia will be given by spraying it into the throat. Anesthesia can also be given in the form of a gel that is applied to the nose. These medications numb the area, preventing gagging and coughing when the bronchoscope is inserted into the throat.
- The doctor will slowly guide the bronchoscope down the back of the throat, past the vocal cords, and into the airway.
- At first you may feel uncomfortable, but you should not feel any pain because you have been given anesthesia.
- Then the doctor will rinse the lungs with saline and then withdraw the fluid. From the results of taking the saline fluid, it will be seen whether there are abnormal cells that need to be tested or not.
- In addition to examining lung tissue, doctors can also take tissue and fluid samples if there are indications of lung cancer.
- If active bleeding is found, the doctor will take action to stop the bleeding.
- If necessary, a sputum sample will be taken to check the culture.
After Bronchoscopy Procedure
After the procedure is complete, you will be monitored for several hours.
The mouth and throat may remain numb for several hours.
At this time, you are not allowed to eat or drink until the numbness wears off.
Its purpose is to prevent food and liquid from entering the airways and lungs.
Things to pay attention to after undergoing a bronchoscopy procedure are:
- You can eat and drink when your mouth and throat are no longer numb and you can swallow normally.
- Start by drinking a glass of water. Then you can eat soft foods, such as soup. Add other foods as you feel comfortable.
- You may experience a mild sore throat, hoarseness, cough, or muscle aches. Don’t worry, this is normal. You can use mouthwash, warm water, and throat lozenges to reduce this discomfort.
Side Effects of Bronchoscopy Examination
Side effects of bronchoscopy are usually just a sensation of discomfort.
The following is an explanation of the various risks that may arise during or after a bronchoscopy:
- Infection of the respiratory tract.
- Bleeding.
- The appearance of allergic reactions.
- Pneumothorax.
- Damage to the respiratory tract.
- Side effects of anesthesia.
Although these risks may exist, it is important to remember that bronchoscopy is generally considered a relatively safe procedure.
A doctor who is experienced in performing this procedure and strict infection prevention measures can help reduce these risks.
See a doctor if you experience the following symptoms after undergoing a bronchoscopy.
- High fever for more than a day.
- Difficulty breathing due to tightness in the chest.
- Chest pain.
- Bleeding when coughing.
If you have problems with lung health, immediately consult a lung specialist.
Where to Perform Bronchoscopy
You can have a bronchoscopy at a hospital, clinic, or community health center that provides this examination facility.
If the health facility you go to does not provide bronchoscopy, the doctor will generally refer you to a hospital that has this facility.
Bronchoscopy Examination Costs
The cost of a bronchoscopy can vary, depending on the healthcare facility you choose.
However, the cost of a bronchoscopy starts from 3,000 to 40,000 in Indian rupees. Well, this cost can also change over time.
You can get relief if you have insurance, such as private insurance, get insurance benefits from your workplace, or the Social Security Administering Body (BPJS).