When you have a persistent cough, blood in your sputum, or an abnormal shadow on a chest X-ray or CT scan, a specialist in Respiratory Medicine may recommend a bronchoscopy for further investigation. While this procedure may sound unfamiliar to many, it is a common tool in respiratory medicine that allows doctors to directly examine the trachea and bronchi, providing diagnostic information for various lung diseases.
Bronchoscopy is a common respiratory procedure. The doctor inserts a thin, flexible endoscope through the mouth or nose into the airways, reaching the trachea and bronchi to visualise the interior of the respiratory tract. This examination helps the doctor assess whether there is inflammation, bleeding, blockage, abnormal secretions, or other suspicious lesions in the airway walls.
Generally, bronchoscopy does not require general anaesthesia. Instead, local anaesthesia and sedation are used to minimise discomfort during the procedure. The examination is safe in most cases, but a small number of people may experience temporary sore throat, hoarseness, or minor haemoptysis (coughing up a small amount of blood). Uncommonly, pneumothorax, infection, or severe bleeding may occur. Your doctor will carefully assess your condition before the procedure and explain the associated risks.
To ensure safety, patients are generally required to fast for at least 6 hours before the examination to prevent vomit from entering the airways. Your doctor or nurse will provide specific instructions based on your individual situation, such as whether you need to adjust your regular medications.
When a patient has certain persistent or unexplained respiratory symptoms, a doctor may recommend bronchoscopy to identify the underlying cause. Common situations include:
If a patient does not show significant improvement after treatment, or if the doctor suspects a deeper problem within the airways or lungs, bronchoscopy may also be considered for further evaluation.
The main role of bronchoscopy is to help the doctor visualise the structure of the airways and, when necessary, collect samples of lung or tracheal tissues, cells, or secretions for laboratory analysis. Therefore, it can be used to diagnose a variety of lung and airway problems, including:
In addition to diagnostic uses, bronchoscopy can also be used therapeutically, for example to remove thick sputum, secretions, or foreign bodies that block the airways, thereby relieving airway obstruction.
Bronchoscopy is one of the common methods used to diagnose lung cancer, especially when imaging tests show a suspicious lesion in the lung or bronchus. The doctor can directly visualise the lesion through the bronchoscope and, if necessary, take tissue samples for pathological examination to determine whether cancer cells or other abnormal changes are present. For lesions located outside the bronchial wall or in the mediastinal lymph nodes, doctors may sometimes use endobronchial ultrasound (EBUS) to obtain a more precise view and perform needle aspiration for cytology.
If the results show abnormalities, early treatment and follow-up can be arranged.
If tissue samples are taken during the procedure, routine pathological results are usually available within a few working days. However, if special staining, bacterial culture, or genetic testing is required, it may take one to two weeks or longer. After the examination, the specialist in Respiratory Medicine will explain the results to the patient and provide recommendations for further treatment or follow-up.
Don’t ignore persistent cough, haemoptysis, or lung shadows
If you have a persistent long-term cough, blood in your sputum, recurrent lung infections, or abnormal shadows on imaging tests, you should not take these lightly. Bronchoscopy can help your doctor accurately identify the cause and plays an important role in diagnosing lung infections, airway diseases, and lung cancers. Consulting a specialist in Respiratory Medicine early can help arrange appropriate tests and treatment according to your individual circumstances.
