What is a Bronchoscopy?
Bronchoscopy is a procedure performed by a doctor specializing in lung diseases, often referred to as a pulmonologist, chest physician, or respiratory physician.
This procedure involves inserting a small camera into the lungs. The camera, which is located at the end of a rubber tube, is inserted through the patient’s nose, down the throat, and into the lungs. This allows the doctor to view the inner structure of the lungs and potentially wash the lungs.
Through bronchoscopy, doctors can diagnose and determine the cause of a lung infection or even identify lung cancer. By directly viewing the lungs, they can gather a lot of information, see the lung airway, and cleanse the inner part of the lungs. This process also helps in detecting the bacteria, virus, or fungus causing a lung infection.
Why do a Bronchoscopy?
Bronchoscopy is performed for primarily two reasons.
Firstly, it is a diagnostic tool, allowing us to identify the specific cause of a lung infection. The inserted camera can help determine whether the infection is due to tuberculosis, bacteria, fungus, viruses, or even cancer. In other words, bronchoscopy is instrumental in pinpointing the source of the lung issue.
Secondly, bronchoscopy is therapeutic and serves as a treatment method for lung problems. For instance, patients admitted to the Intensive Care Unit (ICU) sometimes have lungs that aren’t expanding properly due to an accumulation of mucus and phlegm in the airway. This can cause the lungs to collapse, not expanding as they should. In such cases, bronchoscopy is utilized to wash the airway passage and the lung area, effectively removing the obstructing mucus.
In summary, the purpose of bronchoscopy is twofold: to diagnose the cause of lung conditions and to provide therapeutic treatment for lung problems.
What conditions can be diagnosed with a Bronchoscopy?
Bronchoscopy, or the lung washing procedure, plays a crucial role in diagnosing conditions, particularly suspected cases of tuberculosis (TB) or lung cancer. These are often indicated by symptoms such as prolonged cough that doesn’t respond well to antibiotics or standard treatment.
Typically, a patient exhibiting these symptoms would undergo a CT scan followed by a bronchoscopy. In regions like Malaysia, the most common causes of prolonged cough are either TB or lung cancer.
However, not all causes of chronic cough are as severe as TB or lung cancer. Less dangerous conditions like asthma, bronchitis, or reflux can also lead to chronic coughing.
When it comes to more serious causes of chronic cough, such as TB or lung cancer, bronchoscopy proves invaluable. For instance, if a patient has a dry cough and can’t produce sputum for lab testing, bronchoscopy becomes the preferred method for diagnosis. It can conclusively determine whether the issue is TB, lung cancer, and even specify the type of cancer involved.
In essence, bronchoscopy serves as a potent diagnostic tool, particularly for patients with persistent and chronic cough.
How to prepare for a Bronchoscopy procedure
Before a bronchoscopy procedure, patients are typically asked to fast for at least four hours. Ensuring the stomach is empty is crucial for the smooth execution of the procedure.
Patients must also remove any artificial teeth and avoid any blood-thinning medication. If a tumor is discovered and a biopsy is required, the absence of blood-thinning medication makes the process easier and safer.
Furthermore, patients need to be in a stable condition with regard to blood pressure, heart rate, and oxygen levels before the procedure can commence.
Even if a patient is on a mechanical ventilator or currently in the Intensive Care Unit (ICU), under sedation, bronchoscopy can still be performed with the assistance of an anesthesiologist.
Lastly, an ECG check is particularly important for elderly patients.
These are the prerequisites and preparations required before a patient undergoes a bronchoscopy or lung washing procedure.
How is a Bronchoscopy procedure performed?
The bronchoscopy procedure begins with numbing the patient’s nose and throat using a specialized spray. This ensures the patient will not feel any pain when the small camera is inserted.
Next, the patient is administered a sleeping medication to ensure they are unaware of the ongoing procedure.
Bronchoscopy is a straightforward and safe procedure, typically concluding in about ten minutes. Once the patient is asleep, the small camera, attached at the end of a tube, is inserted into the nose, through the throat, and into the lungs. This allows for a clear visualization of the lung’s inner structure.
Following this, pictures can be taken of the lung’s interior. Water is then flushed into the lungs to dislodge any phlegm, secretions, or foreign bodies lodged within the lung airway.
After flushing, the water is suctioned out of the lung passage, effectively cleaning the lung area. This concludes the bronchoscopy procedure.
What are possible complications with a Bronchoscopy?
Despite being a simple and safe procedure, bronchoscopy may have minor side effects for some patients. These could include a sore throat, cough, or fever following the procedure. However, these symptoms usually resolve by themselves within one to two days, and over-the-counter medication like paracetamol can help alleviate any discomfort.
Rarely, some patients might have an allergic reaction to the medication administered during the bronchoscopy. Therefore, it’s crucial to inform your doctor about any known allergies to medication or food prior to the procedure.
There’s also a minor risk of developing arrhythmia, where the heart rhythm speeds up during the procedure, or experiencing breathlessness or shortness of breath. However, these instances are rare as patients are thoroughly screened before undergoing a bronchoscopy.
In the unlikely event that arrhythmia, oxygen desaturation, or shortness of breath occurs, rest assured that all necessary facilities are available to stabilize the patient’s condition.
In summary, bronchoscopy is a safe and straightforward, non-invasive procedure that yields a wealth of information and can help cleanse the patient’s lungs from obstructing mucus or plaque within the lung airway.
How long does it take to get the results of a Bronchoscopy?
In a private hospital, bronchoscopy results can be expedited, typically available within three to four hours. This allows for a quick determination of whether a patient is positive or negative for tuberculosis (TB).
However, if the issue is potentially cancerous, the results usually take a minimum of three working days. This is because tissue biopsies need to be meticulously analyzed by a pathologist. This examination involves a detailed study of the tissue’s characteristics in order to arrive at a conclusive diagnosis, including the specific type of lung cancer present. This information is crucial as it guides the subsequent treatment plan, which may involve chemotherapy or radiotherapy.
For cases where the objective is to check for TB, results are generally available within three to four hours post-bronchoscopy. Once a positive diagnosis for TB is confirmed, anti-TB treatment can be immediately initiated for the patient.
What can be discovered from the results of a bronchoscopy?
The majority of bronchoscopy procedures reveal no abnormalities, simply facilitating the cleaning of the lungs. In these cases, the structure of the lungs typically appears normal. However, lab results can still identify issues such as tuberculosis, fungal infections, or bacterial infections.
Occasionally, more unusual discoveries can be made. Examples include foreign objects lodged in the lung passage, such as a dislodged tooth, a ball pen cap, a pin, or even a fishbone. If such abnormalities are found, the procedure can be used to remove these foreign bodies, clearing the lung passage. These foreign objects can cause symptoms like prolonged cough, chest discomfort, or even severe pneumonia.
Additionally, bronchoscopy can reveal lung tumors or lesions within the lung airway. In such cases, a biopsy can be taken and the tissue sent to a lab for diagnosis to determine the specific type of lung cancer, whether it be adenocarcinoma, small cell lung cancer, or another type.
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