Bronchoscopy
A test that lets a respiratory physician look inside your airways with a thin camera and, if needed, take small samples to find the cause of a lung problem.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A bronchoscopy lets a respiratory physician look inside your airways and take small samples to find the cause of a lung problem.
- It looks at the larger airways well, but cannot see inside the lung tissue and does not always give a firm answer — about 1 in 10 tests do not reach a diagnosis.
- It is usually a day-case test under throat spray and sedation; if you are sedated you cannot drive, work or sign legal documents for 24 hours.
- Serious problems such as significant bleeding are uncommon, but you should be given clear instructions on the warning signs to watch for afterwards.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Lets the doctor see the airways directly and look for a cause of your symptoms
You are too unwell or your oxygen levels are too low to tolerate the test safely without first being stabilised.
You are awake but drowsy from sedation, with your throat numbed. You can breathe normally around the tube and the team watches your oxygen and heart rate.
Clear written instructions on what is normal, what is a warning sign and who to contact out of hours.
You are awake but drowsy from sedation, with your throat numbed. You can breathe normally around the tube and the...
You rest in recovery until the sedation wears off. You cannot eat or drink until the throat numbness has gone...
Expect to feel tired. If you were sedated, do not drive, work, drink alcohol, use machinery or sign legal...
A sore throat, hoarse voice, mild cough, small specks of blood in your spit and a mild fever can be normal and...
What is a bronchoscopy?
A bronchoscopy is a test that lets a respiratory physician look directly inside your windpipe and the airways of your lungs. A thin, bendy tube with a tiny camera and light on the end (a bronchoscope) is passed through your nose or mouth, past your voice box and into your airways.
It is usually done to find the cause of a problem picked up another way — for example a shadow on a scan, a long-standing cough, coughing up blood, or a possible infection or inflammation. During the test the doctor can take small samples of cells, tissue or fluid to send to the laboratory.
A bronchoscopy is good at looking at the larger airways and taking samples from them, but it cannot see inside the lung tissue itself or reach every small airway. Sometimes it does not reach a firm answer and another test is needed.
This guide explains what the test involves so you can ask better questions. It is not personal medical advice — your respiratory physician will explain what the test can and cannot tell you in your situation.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Bronchoscopy compared with a CT scan
| Point | Bronchoscopy | CT scan of the chest |
|---|---|---|
| What it shows | Inside the airways, directly | Detailed pictures of the whole chest |
| Can it take samples? | Yes, from airways and (with EBUS) glands | No, but can guide a needle biopsy separately |
| Invasive? | Mildly — camera into the airways | No, you lie in a scanner |
| Main role | Look at and sample the airways | Find and map abnormalities |
These tests are often used together rather than instead of each other. Your respiratory physician will explain which you need and why.
Preparing for your procedure
- You will usually be asked not to eat for about 6 hours before, with clear fluids allowed until about 2 hours before — follow the exact times your unit gives you.
- Tell the team about all your medicines, especially blood thinners such as warfarin, aspirin, clopidogrel, apixaban, rivaroxaban, edoxaban or dabigatran. Some people need a temporary change before this procedure, but the plan differs by medicine, the exact procedure and their risk of bleeding or blood clots. Do not stop, skip or restart any of these medicines unless the team responsible for your procedure gives you specific instructions.
- Ask for clear instructions about diabetes medicines, as these often need adjusting on the day.
- Mention any heart or lung condition, allergies, or previous reaction to sedation.
- If you are having sedation, arrange for someone to take you home and, ideally, stay with you overnight.
- Plan not to drive, work, drink alcohol or sign legal documents for 24 hours after sedation.
- Bring your inhalers and a list of your medicines with you.
What happens
You will usually be awake but relaxed. Local anaesthetic is sprayed onto the back of your throat to numb it, and most people are given a sedative through a small cannula in the back of the hand to help them feel calm and drowsy. Your oxygen level and heart rate are monitored throughout, and you are given oxygen through your nose.
The bronchoscope is passed gently through your nose or mouth, past your voice box and into your airways. It is normal to cough as it goes through. The doctor looks at the lining of your airways and, if needed, takes samples using small brushes, fluid washes or tiny forceps. You can still breathe around the tube the whole time.
The test itself usually takes about 20 to 30 minutes. Afterwards you rest in a recovery area until the sedation wears off and your throat is no longer numb.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- You are too unwell or your oxygen levels are too low to tolerate the test safely without first being stabilised.
- You have a bleeding tendency or are on blood thinners that cannot be safely paused, particularly if biopsies are planned.
- An uncontrolled heart rhythm problem or recent heart attack means the risk currently outweighs the benefit.
- The information needed could be obtained by a less invasive test, such as a scan or a sputum sample.
Delay or rearrange if…
- You have an active chest infection or are acutely wheezy, until this is treated and more stable.
- Your blood thinners have not been managed according to a clear plan.
- Your asthma or COPD is poorly controlled and could be optimised first.
- You cannot arrange a responsible adult to take you home after sedation.
- There is a chance you could be pregnant and this has not been discussed.
Alternatives to discuss
- A CT scan of the chest, which gives detailed pictures without entering the airways
- A sputum sample sent for infection or cell testing, where appropriate
- A CT-guided lung biopsy for lesions in the outer lung that the bronchoscope cannot reach
- EBUS or a surgical biopsy where lymph glands or lung tissue need fuller sampling
- Watchful waiting with repeat imaging for small or low-risk findings, if your team advises
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Lets the doctor see the airways directly and look for a cause of your symptoms
- Allows samples to be taken to test for infection, inflammation or cancer
- Can help confirm or rule out a suspected diagnosis seen on a scan
- Can sometimes treat a problem, such as clearing a mucus plug or controlling bleeding
- May avoid the need for a bigger, more invasive operation to get a diagnosis
Risks & complications
- A sore throat or hoarse voice for a day or two
- Coughing during and for a short time after the test
- Coughing up small amounts of blood for a few hours, especially after a biopsy
- Feeling tired or drowsy for several hours from the sedation
- A mild fever in the first 24–48 hours that usually settles
- A drop in oxygen level during the test, managed with extra oxygen
- Strain on the heart or an irregular heartbeat (reported in up to about 5 in 100 people, more likely with existing heart or lung disease)
- A chest infection needing antibiotics
- Worsening of breathing, particularly in people with asthma or COPD
- Significant bleeding (about 1 in 1000 people)
- A collapsed lung (pneumothorax), more likely if a biopsy of lung tissue is taken
- Infection (less than 1 in 500 people)
- Damage to teeth, or rarely bruising around the eyes
- Death (less than 1 in 1000 people, mainly in those who are already very unwell)
The biggest factors are your existing heart and lung health and whether a biopsy is taken. Significant bleeding is uncommon but more likely with biopsies and in people on blood thinners, so be honest about every medicine you take. Ask your respiratory physician what samples they plan to take, how this changes your personal risk, and exactly what warning signs to watch for afterwards.
Published figures to discuss
Bronchoscopy is generally well tolerated, but the chance of a problem depends heavily on how unwell you already are, your heart and lung health, and whether biopsies are taken. The rates below come from NHS patient information and UK guidance and are cautious, broad figures rather than a precise prediction for you. Diagnostic 'failure' here means the test does not reach a firm answer, not that anything went wrong.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Significant bleeding | About 1 in 1000 people | More likely with biopsies and in people on blood thinners. Small specks of blood in spit are common and not the same thing. | British Thoracic Society — Diagnostic flexible bronchoscopy guideline (NICE-accredited)brit-thoracic.org.ukPublished figure |
| Infection | Less than 1 in 500 people | A mild fever in the first day or two is common and usually settles without antibiotics. | British Thoracic Society — Diagnostic flexible bronchoscopy guideline (NICE-accredited)brit-thoracic.org.ukPublished figure |
| Heart strain or irregular heartbeat | Up to about 5 in 100 people | More likely in people with existing heart or lung disease; monitored throughout the test. | Guide sourcesClinical context |
| Test does not reach a diagnosis | About 1 in 10 people | A further test such as a scan or different biopsy may then be needed. | British Thoracic Society — Diagnostic flexible bronchoscopy guideline (NICE-accredited)brit-thoracic.org.ukPublished figure |
| Death | Less than 1 in 1000 people | Mainly in people who are already very unwell. Rare, but it is why the test is only done when justified. | British Thoracic Society — Diagnostic flexible bronchoscopy guideline (NICE-accredited)brit-thoracic.org.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no wound to heal, but you will need a few hours to recover from the sedation and numb throat, and then you wait for the laboratory results.
- A sore or scratchy throat and a hoarse voice for a day or two
- Coughing up small specks of blood for a few hours
- Feeling drowsy and forgetful for the rest of the day after sedation
- A mild fever in the first day or so that settles on its own
- Waiting one to two weeks for results, which can feel unsettling
Aftercare
- Do not eat or drink until the numbness in your throat has fully worn off, usually about an hour.
- Have a responsible adult take you home and stay with you if you were sedated.
- Rest for the remainder of the day and avoid alcohol for 24 hours.
- Soothe a sore throat with sips of water, lozenges or simple pain relief such as paracetamol if needed.
- Take your usual inhalers and medicines as advised, and ask when to restart any blood thinners that were stopped.
- Keep your follow-up appointment so your results can be explained to you.
- Save the unit's contact or out-of-hours number in case you have warning signs.
- Someone booked to drive you home and stay over if sedated
- Day off work and no driving planned for 24 hours after sedation
- Fasting instructions and timings understood
- Plan agreed for stopping and restarting blood thinners
- Inhalers and medicines list packed
- Unit and out-of-hours contact number saved
- Follow-up appointment for results noted
⚠ Get urgent help if…
- Coughing up more than small specks of blood, or bringing up larger amounts of fresh blood
- Increasing breathlessness or chest tightness
- Sharp or worsening chest pain
- A high fever, shivering or feeling very unwell (possible infection)
- A fast, pounding or irregular heartbeat
- Severe or persistent sore throat with difficulty swallowing or breathing
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A normal-looking airway and reassuring samples can help rule out some problems, but a bronchoscopy cannot rule out every lung condition — it only sees and samples part of the lung. The most useful results usually come from the laboratory tests on the samples taken, which is why the answer is rarely given on the day.
In roughly 1 in 10 tests the result is inconclusive and a further test is needed. Your respiratory physician will explain what your result means, what it cannot prove, and what the next step is.
A bronchoscopy gives a snapshot in time. If your symptoms change, or a result is unclear, the test may need to be repeated or followed by a different test such as a CT scan or a needle biopsy. A normal result now does not guarantee your airways will stay healthy in the future.
Related tests, treatments or support
A bronchoscopy is often planned alongside or after a CT scan of the chest, and may be combined with EBUS to sample lymph glands in the same sitting. If samples cannot reach a diagnosis, a CT-guided lung biopsy or a surgical biopsy is sometimes considered.
Follow-up & long-term care
You will usually be given a follow-up appointment, by phone or in clinic, to go through your results once the laboratory work is complete — often within 1–2 weeks, though some tests take longer. You should be told who to contact in the meantime and what to do if you develop warning signs.
Repeat, follow-on and what comes next
- About 1 in 10 tests are inconclusive and need repeating or a different test.
- Some infection cultures take weeks, so the full picture may not be clear straight away.
- A normal airway does not exclude disease deeper in the lung, which may need CT-guided or surgical sampling.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear written instructions on what is normal, what is a warning sign and who to contact out of hours.
- A named route back to the respiratory team if you become unwell.
- A defined plan and appointment for explaining your results, with a contact if they are delayed.
- A clear plan for restarting any blood thinners that were stopped.
- Onward referral arranged promptly if a serious diagnosis is found or a further test is needed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the test is done under throat spray alone or with sedation, and the monitoring needed
- The respiratory physician's fee and the endoscopy unit or facility fee
- Whether biopsies, washings or brushings are taken and how many samples are sent
- Laboratory and pathology charges for analysing the samples
- Whether EBUS or other add-on techniques are used in the same sitting
- A follow-up appointment to discuss the results, and any further tests if the result is inconclusive
- The respiratory physician's fee and the endoscopy or facility fee
- Sedation and monitoring costs, if used
- Laboratory and pathology fees for all samples taken
- The cost of the follow-up appointment to explain your results
- What happens, and what it costs, if the test is inconclusive and needs repeating or a further test
- The cancellation policy and what is covered if a complication needs treatment
On the NHS? A bronchoscopy is a standard NHS test when clinically indicated; private access is mainly used for speed, choice of consultant or a second opinion rather than because the NHS does not offer it.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told that the test may not reach a diagnosis and could need repeating.
- Sedation and 24-hour driving and work restrictions not being made clear before the day.
- Blood thinners not being properly reviewed before a planned biopsy.
- No clear written warning signs or out-of-hours contact for after you go home.
- Not being told who will explain your results and when.
Marketing red flags
- Describing it as a 'quick, simple look' without mentioning sedation, recovery and warning signs.
- Implying a normal bronchoscopy rules out all lung disease, including cancer.
- Promising same-day results when key samples take days to weeks.
- Not discussing alternatives such as a CT scan or sputum test where they would be reasonable.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Why do I need a bronchoscopy rather than another test, and what are you hoping to find?
- What samples do you plan to take, and does taking a biopsy change my risk of bleeding?
- Will I be sedated, and what does that mean for getting home and the next 24 hours?
- What will this result change about my treatment, and what happens if it is normal or inconclusive?
- What warning signs should make me contact you afterwards, and who do I call out of hours?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a bronchoscopy available on the NHS?
Will it hurt?
Will I be asleep?
When will I get my results?
Can I drive home afterwards?
What if the test does not find the cause?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cancer Research UK — Bronchoscopy Patient.info — Bronchoscopy British Thoracic Society — Diagnostic flexible bronchoscopy guideline (NICE-accredited) North Tees and Hartlepool NHS FT — Bronchoscopy patient information North Bristol NHS Trust — Bronchoscopy
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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