Gallbladder polyps: Symptoms, causes, and treatments

Polyps in the gallbladder may not cause any symptoms. Depending on the type of polyps, they can be benign, be a sign of inflammation, or potentially lead to cancer.

Polyps are abnormal tissue growths.

Most people with gallbladder polyps do not experience symptoms. Doctors usually discover the polyps incidentally on ultrasound or CT scans.

Although some gallbladder polyps can develop into cancer, the vast majority of polyps are noncancerous. As long as the polyps are smaller than 1 centimeter (cm) in diameter and cause no symptoms, treatment is unnecessary.

This article discusses the symptoms and potential complications of gallbladder polyps. It also explains the association between gallbladder polyps and cancer and looks at the treatment options.

A polyp is an abnormal growth of tissue. Some polyps are small, flat bumps, while others hang from tiny stalks.

Polyps can form in various parts of the body, including the gallbladder. Researchers estimate that gallbladder polyps affect 0.3–9.5% of the population.

There are three main types of gallbladder polyps: pseudopolyps, inflammatory polyps, and true gallbladder polyps.

Pseudopolyps

Pseudopolyps, also known as cholesterol polyps, are the most common type, accounting for 60–90% of all gallbladder polyps. Pseudopolyps are noncancerous, cholesterol-filled growths.

Their presence sometimes indicates an underlying gallbladder issue, such as chronic cholecystitis. This is the term for gallbladder inflammation, which occurs when the gallbladder does not empty sufficiently.

Inflammatory polyps

Inflammatory polyps account for 5–10% of all gallbladder polyps. They indicate inflammation in the wall of the gallbladder.

Doctors usually find inflammatory polyps in people who have experienced cholecystitis more than once and those who have acute biliary colic. Biliary colic can occur when a gallstone blocks the duct of the gallbladder, and it typically results in pain after eating.

Inflammatory polyps are not associated with gallbladder cancer.

True gallbladder polyps

True gallbladder polyps are rare and have the potential to become cancerous.

These polyps typically measure 5–20 millimeters (mm) in diameter. Any that are larger than 1 cm are more likely to become cancerous.

When a person has larger polyps, the doctor may recommend removing the gallbladder.

Share on PinterestAn ultrasound view of the gallbladder showing a polyp inside it.
James Heilman, MD, CC BY-SA 4.0, via Wikimedia Commons

Gallbladder polyps do not always cause symptoms. In many cases, doctors find them unexpectedly on ultrasound or CT scans.

However, gallbladder polyps can sometimes cause the following symptoms:

• discomfort in the upper right side of the abdomen
• bloating
• nausea
• food intolerances

People with high levels of cholesterol or salts in their bile have an increased risk of developing gallbladder polyps. The liver produces bile and stores it in the gallbladder. The gallbladder’s main function is to help the body digest fat.

Gallbladder polyps are also associated with the formation of gallstones. Many people have both gallbladder polyps and gallstones.

The following health issues may increase a person’s risk of developing true gallbladder polyps:

• familial polyposis, an inherited condition
• Gardner syndrome, a type of familial polyposis
• Peutz-Jeghers syndrome, a genetic condition
• hepatitis B, a viral infection that can be acute or chronic

The majority of gallbladder polyps are pseudopolyps or inflammatory polyps. These do not cause complications and are not associated with cancer.

However, doctors regularly monitor all gallbladder polyps, regardless of their type. Removal of the gallbladder is only necessary if people experience symptoms or a polyp grows larger than 1 cm. The most significant complication of true gallbladder polyps is gallbladder cancer.

The biopsy procedure that doctors sometimes use to confirm the diagnosis can also potentially cause complications. These include bleeding, infection, and the leaking of bile.

Only true gallbladder polyps are associated with cancer. The stages of gallbladder cancer range from 0 to 5, with stage 5 being the most advanced.

The 5-year survival rate for stage 1 gallbladder cancer is less than 50%.

Doctors detect fewer than 10% of gallbladder cancer cases when they are at stage 0 or 1. They diagnose the majority of cancerous gallbladder polyps at a more advanced stage.

Factors that can increase a person’s risk of developing gallbladder cancer include:

• being over 50 years of age
• being of Indian ethnicity
• having a history of primary sclerosing cholangitis
• having a flat, or sessile, polyp, along with thickening of the gallbladder wall

Meanwhile, research indicates that people with pseudopolyps or inflammatory gallbladder polyps have almost no risk of developing gallbladder cancer.

Nonetheless, doctors monitor all gallbladder polyps closely. Those that grow larger than 1 cm have a higher likelihood of becoming cancerous. When a person has a polyp of this size, the doctor will advise removing the gallbladder.

Currently, the only treatment option for gallbladder polyps is the surgical removal of the gallbladder. However, as people with high cholesterol have an increased risk of developing cholesterol polyps, lowering cholesterol levels in the blood may help prevent cholesterol polyps from forming in the first place.

The American College of Cardiology and similar institutions recommend dietary changes for people with high cholesterol.

A low cholesterol diet includes plenty of the following foods:

• vegetables
• fruits
• whole grains
• legumes
• low fat dairy
• low fat poultry
• fish
• seafood
• nontropical vegetable oils

People with high cholesterol should also limit their intake of:

• sweets
• sugar-sweetened beverages
• red meats

Another way to lower cholesterol is through exercise. People should aim to exercise for a minimum of 40 minutes at least three times a week. The exercise should be aerobic and moderate to vigorous in intensity.

Some people may also need to take medication that lowers their cholesterol.

People with gallbladder polyps may not experience symptoms. Most gallbladder polyps are noncancerous, but they still require regular monitoring.

Surgery is necessary if polyps cause symptoms or are larger than 1 cm. Doctors also recommend surgery when a polyp has grown by 2 mm or more since the person’s last checkup.

True gallbladder polyps are rare, but they can cause gallbladder cancer. The standard treatment is the surgical removal of the gallbladder. Survival rates for people with this type of cancer are higher when doctors detect the cancer at an early stage.

Gallbladder polyps: Symptoms, causes, and treatments

Polyps in the gallbladder may not cause any symptoms. Depending on the type of polyps, they can be benign, be a sign of inflammation, or potentially lead to cancer.

Polyps are abnormal tissue growths.

Most people with gallbladder polyps do not experience symptoms. Doctors usually discover the polyps incidentally on ultrasound or CT scans.

Although some gallbladder polyps can develop into cancer, the vast majority of polyps are noncancerous. As long as the polyps are smaller than 1 centimeter (cm) in diameter and cause no symptoms, treatment is unnecessary.

This article discusses the symptoms and potential complications of gallbladder polyps. It also explains the association between gallbladder polyps and cancer and looks at the treatment options.

A polyp is an abnormal growth of tissue. Some polyps are small, flat bumps, while others hang from tiny stalks.

Polyps can form in various parts of the body, including the gallbladder. Researchers estimate that gallbladder polyps affect 0.3–9.5% of the population.

There are three main types of gallbladder polyps: pseudopolyps, inflammatory polyps, and true gallbladder polyps.

Pseudopolyps

Pseudopolyps, also known as cholesterol polyps, are the most common type, accounting for 60–90% of all gallbladder polyps. Pseudopolyps are noncancerous, cholesterol-filled growths.

Their presence sometimes indicates an underlying gallbladder issue, such as chronic cholecystitis. This is the term for gallbladder inflammation, which occurs when the gallbladder does not empty sufficiently.

Inflammatory polyps

Inflammatory polyps account for 5–10% of all gallbladder polyps. They indicate inflammation in the wall of the gallbladder.

Doctors usually find inflammatory polyps in people who have experienced cholecystitis more than once and those who have acute biliary colic. Biliary colic can occur when a gallstone blocks the duct of the gallbladder, and it typically results in pain after eating.

Inflammatory polyps are not associated with gallbladder cancer.

True gallbladder polyps

True gallbladder polyps are rare and have the potential to become cancerous.

These polyps typically measure 5–20 millimeters (mm) in diameter. Any that are larger than 1 cm are more likely to become cancerous.

When a person has larger polyps, the doctor may recommend removing the gallbladder.

Share on PinterestAn ultrasound view of the gallbladder showing a polyp inside it.
James Heilman, MD, CC BY-SA 4.0, via Wikimedia Commons

Gallbladder polyps do not always cause symptoms. In many cases, doctors find them unexpectedly on ultrasound or CT scans.

However, gallbladder polyps can sometimes cause the following symptoms:

• discomfort in the upper right side of the abdomen
• bloating
• nausea
• food intolerances

People with high levels of cholesterol or salts in their bile have an increased risk of developing gallbladder polyps. The liver produces bile and stores it in the gallbladder. The gallbladder’s main function is to help the body digest fat.

Gallbladder polyps are also associated with the formation of gallstones. Many people have both gallbladder polyps and gallstones.

The following health issues may increase a person’s risk of developing true gallbladder polyps:

• familial polyposis, an inherited condition
• Gardner syndrome, a type of familial polyposis
• Peutz-Jeghers syndrome, a genetic condition
• hepatitis B, a viral infection that can be acute or chronic

The majority of gallbladder polyps are pseudopolyps or inflammatory polyps. These do not cause complications and are not associated with cancer.

However, doctors regularly monitor all gallbladder polyps, regardless of their type. Removal of the gallbladder is only necessary if people experience symptoms or a polyp grows larger than 1 cm. The most significant complication of true gallbladder polyps is gallbladder cancer.

The biopsy procedure that doctors sometimes use to confirm the diagnosis can also potentially cause complications. These include bleeding, infection, and the leaking of bile.

Only true gallbladder polyps are associated with cancer. The stages of gallbladder cancer range from 0 to 5, with stage 5 being the most advanced.

The 5-year survival rate for stage 1 gallbladder cancer is less than 50%.

Doctors detect fewer than 10% of gallbladder cancer cases when they are at stage 0 or 1. They diagnose the majority of cancerous gallbladder polyps at a more advanced stage.

Factors that can increase a person’s risk of developing gallbladder cancer include:

• being over 50 years of age
• being of Indian ethnicity
• having a history of primary sclerosing cholangitis
• having a flat, or sessile, polyp, along with thickening of the gallbladder wall

Meanwhile, research indicates that people with pseudopolyps or inflammatory gallbladder polyps have almost no risk of developing gallbladder cancer.

Nonetheless, doctors monitor all gallbladder polyps closely. Those that grow larger than 1 cm have a higher likelihood of becoming cancerous. When a person has a polyp of this size, the doctor will advise removing the gallbladder.

Currently, the only treatment option for gallbladder polyps is the surgical removal of the gallbladder. However, as people with high cholesterol have an increased risk of developing cholesterol polyps, lowering cholesterol levels in the blood may help prevent cholesterol polyps from forming in the first place.

The American College of Cardiology and similar institutions recommend dietary changes for people with high cholesterol.

A low cholesterol diet includes plenty of the following foods:

• vegetables
• fruits
• whole grains
• legumes
• low fat dairy
• low fat poultry
• fish
• seafood
• nontropical vegetable oils

People with high cholesterol should also limit their intake of:

• sweets
• sugar-sweetened beverages
• red meats

Another way to lower cholesterol is through exercise. People should aim to exercise for a minimum of 40 minutes at least three times a week. The exercise should be aerobic and moderate to vigorous in intensity.

Some people may also need to take medication that lowers their cholesterol.

People with gallbladder polyps may not experience symptoms. Most gallbladder polyps are noncancerous, but they still require regular monitoring.

Surgery is necessary if polyps cause symptoms or are larger than 1 cm. Doctors also recommend surgery when a polyp has grown by 2 mm or more since the person’s last checkup.

True gallbladder polyps are rare, but they can cause gallbladder cancer. The standard treatment is the surgical removal of the gallbladder. Survival rates for people with this type of cancer are higher when doctors detect the cancer at an early stage.

Modern understanding of gallbladder polyps

What are gallbladder polyps?

A polyp of the gallbladder can be called any round formation, “growing” from the wall of the gallbladder and not like a stone.

What are gallbladder polyps?

All found polyps can be divided into “true” and “pseudo-polyps”.

True ones make up no more than 5% of all gallbladder polyps found on ultrasound and are essentially a tumor (that is, a neoplasm).

Pseudopolyps are any changes in the wall of the gallbladder that resemble a tumor (polyp) in their appearance, but are not inherently one. Up to 90% of gallbladder pseudopolyps are cholesterol polyps.

What are gallbladder cholesterol polyps and why do they occur?

Cholesterol polyps are rounded areas of accumulation of cholesterol in the mucous membrane of the gallbladder, and therefore they are referred to as pseudopolyps (that is, they are not a tumor), which means that they cannot become malignant (cannot degenerate into gallbladder cancer).

Cholesterol polyps appear as a result of excess cholesterol in the blood. The fact is that our body removes excess cholesterol from the blood with bile, which is able to dissolve it. But if there is too much cholesterol or the composition of bile is disturbed in a person (the content of bile acids in it is reduced or the ratio of their varieties is changed) – two options for further development of events are possible: – gallstone disease develops.

Which path the excess cholesterol will take in bile depends on its composition and dissolving power.

Why are polyps dangerous and why do you need to know about their existence?

Most polyps, including true ones, do not cause any symptoms. Complaints may appear already in the later stages, when a true polyp degenerates into gallbladder cancer. Therefore, if there are risks of polyps (listed below), it is important to check the condition of your gallbladder on ultrasound.

However, cholesterol polyps can sometimes be accompanied by discomfort or dull pain in the right hypochondrium, nausea, bloating, intolerance to fatty foods and other non-specific manifestations, but there is no exact understanding of why these symptoms occur (and whether they are associated with polyps) .

In addition, cholesterol polyps, as a rule, grow on the so-called “thin stalk”, from which they can tear off and block the bile ducts on the way out of the gallbladder. In this case, the situation is comparable to stone blockage in cholelithiasis – there is acute pain in the right hypochondrium, which may be accompanied by vomiting, fever, jaundice, the development of acute cholecystitis or pancreatitis. This situation may require calling an ambulance and even surgery.

Who is at higher risk for gallbladder polyps?

Based on the analysis of large studies, it was found that gallbladder polyps occur more often in persons:

1. Males (exception: cholesterol polyps, more common in multiparous women).
2. With obesity, concentrated in the abdomen.
3. CC with fatty hepatosis (moreover, the stronger the fatty liver, the larger the polyps in the gallbladder).
4. High diastolic pressure (diastolic pressure is your pressure when the heart is relaxed. It is also called “lower” pressure, and on the tonometer it displays the second number. If this number is 90 or higher – diastolic pressure can be considered high).
5. Patients with viral hepatitis B (positive blood test for HBsAg).

How can polyps be detected and monitored?

Abdominal ultrasonography can detect gallbladder polyps. If there is a need to examine the polyp better (for example, when the specialist is not completely sure whether it is a true polyp or pseudo, benign or malignant), you may be ordered to perform an endo-ultrasound (or EUS – endoscopic ultrasonography). Endo-ultrasound is performed in the same way as gastroscopy, only there is also an ultrasound sensor at the tip of the endoscopic apparatus. This study allows you to view the internal organs much closer – through the wall of the stomach and / or duodenum.

Your doctor will tell you how often you need to have a follow-up ultrasound. The frequency of observation depends on the initial size and appearance of the found polyps, as well as on the risks of their malignant transformation in each case.

Is it possible to “cure” gallbladder polyps?

Cholesterol pseudopolyps – yes. Treatment will include “washing out” cholesterol from the gallbladder wall, normalizing blood cholesterol levels, and dealing with conditions that increase the risk of polyps (overweight, high blood pressure, fatty liver, hepatitis B).

True polyps and some types of pseudopolyps can only be treated surgically, that is, by removing the gallbladder.

Who needs to remove the gallbladder if there are polyps in it?

It is necessary to remove the gallbladder in the following cases:

1. If a single polyp of 10 mm or more is found in the gallbladder during ultrasound; and also if, during the control ultrasound after 6 months, a single smaller polyp has grown by 2 mm or more.
2. If it is impossible to say with 100% certainty that the polyp is NOT cancerous.
3. If there is a risk of polyp degeneration into gallbladder cancer (the doctor determines according to the examination).
4. If there is concomitant cholelithiasis that caused 2 or more biliary colic, cholecystitis or pancreatitis.

Also consider removal of the gallbladder:

1. If there are many stones in the gallbladder that are more than 1/4 full.
2. In case of poor contractility of the gallbladder, determined by ultrasound of the gallbladder with a choleretic breakfast (ejection fraction less than 30%).
3. Failure to treat polyps with diet/drugs for 6-12 months.

If you are at risk of developing gallbladder polyps, we recommend that you have an abdominal ultrasound to rule out their presence. If, according to the results of ultrasound, you have found gallbladder polyps, be sure to consult a gastroenterologist: if true polyps are found that do not require surgical treatment, the doctor will tell you how often it is necessary to perform control ultrasounds and whether additional examination is needed, and if cholesterol polyps are found, he will be able to prescribe medication for you.

If you have indications for surgical treatment, remember that after removal of the gallbladder, the load on other organs of the gastrointestinal tract increases, therefore, the risk of exacerbation of chronic diseases of the digestive system that already existed before the operation increases, and it is also possible to develop new ones, such as postcholecystectomy syndrome. Our center has developed special programs that will help prevent possible complications of the operation, as well as maintain and improve the quality of life after cholecystectomy – the programs “Preparation for removal of the gallbladder” and “Rehabilitation after removal of the gallbladder”. If concomitant cholelithiasis is an indication for cholecystectomy, you can use the “Gallbladder Rescue with Stones” program, designed to treat gallstone disease without surgery.

All about gallbladder polyps

A polyp in the gallbladder is a tumor formation in the walls of the gallbladder. Cancer cells can hide inside it. Therefore, a person with a gallbladder polyp automatically falls into the risk group. If the neoplasm has grown to 1 cm, doctors begin to talk about the threat of oncology.

What should be done to diagnose and treat gallbladder polyps ? To solve this problem, the first step for the patient is to make an appointment with a gastroenterologist. After the initial examination, the doctor may prescribe additional tests:

• Laboratory tests
• Ultrasound of the gallbladder
• CT scan of the gallbladder
• MRI of the gallbladder
• Histological analysis.

The gallbladder is a small organ that stores bile and passes it from the liver to the small intestine. A gallbladder polyp is a small, abnormal growth of tissue with a stalk protruding from the lining of the inside of the gallbladder. Although gallbladder polyps can be cancerous, about 95% of gallbladder polyps are benign. The size of a gallbladder polyp is often a sign of cancer:

• small polyps less than 10 mm in diameter – usually benign and in most cases do not need treatment
• polyps larger than 10 mm in diameter are more likely to become cancerous.

Symptoms of gallbladder polyps

In many cases, patients with gallbladder polyps do not have symptoms. But mostly patients complain about the following manifestations:

• occasional pain in the right side (hypochondria)
• nausea
• vomiting.

It is not clear what causes gallbladder polyps, but some risk factors are suspected by the doctor:

• age
• a health condition such as obesity or diabetes
• association with fat metabolism.

How a doctor diagnoses a gallbladder polyp

Most gallbladder polyps are diagnosed during an abdominal ultrasound. If the gastroenterologist suspects the presence of gallbladder polyps, then the patient may be assigned specialized studies, such as:

• Abdominal MRI
• Abdominal CT
• endoscopic ultrasound of the gallbladder.

Ultrasound can detect a polyp, but it cannot answer the question about the quality of the cells inside the growth. But in the course of CT and MRI of the liver and gallbladder, doctors manage not only to detect polyps, but also to determine its nature (evil / benign formation) by the quality of the signal without any biopsy. The signal from polyps is different than from a malignant tumor, which is fixed by a tomograph.

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Scientific sources:

1. Mishin V. Yu. 1999. – No. 1.1. C. 69-70.
2. Abramovich Yu. A. Polyposis of the gallbladder / Yu. A. Abramovich, Yu. M. Negin // Vestn. hir. 1966. – No. 10. – S. 125.
3. Akberov R.F. Modern methods of radiation diagnosis of diseases of the organs of the hepatopancreatoduodenal zone / R.F. Akberov, I.I. Kamalov // Kazan, honey. magazine – 1998. – T. 79, No. 3. – S. 181-184.
4. Unresolved issues of ultrasound diagnosis of gallbladder polyps / M. N. Nikitina, N. G. Lud, S. I. Pimanov, P. P. Makarov, M. N. Medvedev, G. F. Sapko, S. V. Lyarsky , A. I. Poboykin // News of Radiation Diagnostics. 2000. – No. 2. – S. 74.
5. Leishner U. A. A practical guide to diseases of the biliary tract / U. A. Leishner. M. : GEOTAR-MED, 2001. – 264 p.

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