Gallbladder Polyps

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Published: January 26, 2017
Last reviewed: October 24, 2017

What is a gallbladder polyp?

Gallbladder polyp is an abnormal growth that protrudes from the inner surface of the gallbladder into its lumen.

The polyps greater than 5 mm can be detected by ultrasound.

In about 5% of the cases, the polyps become cancerous [1].

Gallbladder polyps bigger than 10 mm are at increased risk to develop into cancer, so they are usually removed.

 

Types of Gallbladder Polyps

Gallbladder polyps can be benign or malign [1]:

  • Benign polyps:
    • Pseudotumors:
      • Cholesterol polyps (most common, usually <10 mm, commonly multiple, with a stalk, do not develop into cancer)
      • Inflammatory polyps (<10 mm, do not develop into cancer)
    • Epithelial tumors: adenomas (5-20 mm, usually solitary and accompanied with gallstones, can develop into cancer)
    • Adenomyomatosis – a benign noninflammatory lesion that can develop into cancer
    • Mesenchymatous tumors: fibroma, lipoma, and hemangioma, leiomyoma, granular cell tumor
  • Malign polyps:
    • Adenocarcinoma
    • Mucinous cystadenoma
    • Squamous cell carcinoma
    • Adenoacanthoma

Risk Factors For Polyps

  • Age >60
  • Female sex
  • Gallstones
  • Primary sclerosing cholangitis
  • Chronic hepatitis B
  • Congenital Peutz-Jeghers and Gardner syndrome
  • Reference: [1]

Symptoms

In most cases, gallbladder polyps do not cause any symptoms, but sometimes they can cause:

  • Pain in the right upper abdominal quadrant
  • Nausea, vomiting

Polyps are often associated with gallstones [1].

Rare complications include acute acalculous cholecystitis, jaundice and cancer. Cholesterol polyps can detach, lodge in the common bile duct and cause pancreatitis [1].

Diagnosis

Gallbladder polyps greater than 5 mm can be detected by an abdominal ultrasound. An ultrasound can reveal the number and size of the polyps and distinguish between a cholesterol polyp and adenoma but cannot reliably distinguish between a benign and malign polyp (Picture 1[1].

Gallbladder polyp sonogram

Picture 1. An ultrasound image (sonogram) of a 2 cm gallbladder polyp
(source: Ultrasoundcases, by permission)

Endoscopic ultrasound (EUS) (Picture 2) and high-resolution ultrasound (HRUS) seem to be equally effective in differentiating between benign and malign polyps [1].

Gallbladder adenoma and polyp

Picture 2.  Contrast-enhanced endoscopic ultrasonography (EUS) of gallbladder adenoma – a benign tumor (A) and cholesterol polyp (B) 
(source: Science Central)

Computed tomography (CT), magnetic resonance imaging (MRI) and intravenous cholecystography are less sensitive in detective gallbladder polyps than an ultrasound [1].

Risk Factors For Development Into Cancer

  • Age >50
  • Diabetes mellitus
  • Gallstones or biliary sludge
  • Primary sclerosing cholangitis
  • Chronic infection with Salmonella typhi
  • Porcelain gallbladder (calcification of the gallbladder wall)
  • Polyp that is single, greater than 10 mm, without a stalk (“sessile”) and causes symptoms
  • References: [1,2,5]

Treatment

A doctor will likely suggest gallbladder removal (cholecystectomy) when [1]:

  • Cholesterol polyps and other polyps with low cancerous potential are greater than 10 mm
  • Adenomas and other polyps greater than 6 mm are associated with increased risk factors for cancer
  • Polyps of any size are associated with primary sclerosing cholangitis

A surgical technique of choice for the removal of the gallbladder with polyps is laparoscopic cholecystectomy [1]. In polyps larger than 18 mm, which are commonly cancerous, an open surgery with gallbladder, partial liver and regional lymph node removal is indicated [1].

Gallbladder polyps

Picture 3. Multiple cholesterol gallbladder polyps in a removed and opened gallbladder (source: Wikimedia, CC license)

Follow-Up

Small polyps that are not removed should be followed up at regular intervals, for example, every 6 to 12 months [1].

Diet

There is no specific diet that would prevent gallbladder polyps. Since gallbladder polyps are commonly associated with gallstones, the diet that can help prevent gallstones may also reduce the risk of gallbladder polyps [3,4]. Main points:

  • Maintain healthy body weight.
  • Do not skip meals.
  • If you intend to lose weight, do it slowly.
  • Consume less saturated fats (red meat, cheese) and cholesterol (eggs, shrimps, organ meats).

Is it possible to flush gallbladder polyps?

There in NO EVIDENCE about the effectiveness of any drug, remedy or juice that would soften and flush gallbladder polyps.

35 Responses to Gallbladder Polyps

  1. Kalyani pradhan says:

    On 7th February I went for ultra sound,it was shown 2mm 2polyps in my gallbladder,again I went for ultra sound on 10th November..but the report says no calculus or any SOL is seen in lumen,is this possible or ultra sound machine problem

    • Kalyani pradhan says:

      Sorry 4th November

      • Jan Modric says:

        It would be possible that polyps were not actually polyps but small stones. Such small stones may be spontaneously flushed out of gallbladder together with bile. On the other hand, 2 mm polyps may be hard to detect and easy to miss.

  2. David says:

    I have a 2mm gallbladder pylop. As mentioned in the above article, Consume less saturated fats (red meat, cheese) and cholesterol (eggs, shrimps, organ meats).

    If I only eat egg white, will it make my pylop grow bigger?

    Does protein cause pylops to grow bigger?

    Thank you and looking forward to your advice.

    • Jan Modric says:

      The diet mentioned above in the article is for prevention of gallstones. I am not aware of any diet that would prevent the growth of a polyp when you already have it, especially if you do not have any gallstones.

  3. Elizabeth says:

    I’ve been having pain where my galbladder is for years, in may I had an ultrasound and they said there was a small polyp in my galbladder, only one seen, (5mm) then I went for another one in September and the ultrasound tech said there was about 5 the biggest measuring 6mm , I have an appointment with a new gastro because I’ve been throwing up for the past 6 months, should I be concerned

    • Jan Modric says:

      Gallbladder polyps only rarely cause pain or vomiting, so I suggest you to ask a doctor if your symptoms could be from polyps, some other gallbladder issue or some other problem. Polyps 5-6 mm is size are rarely cancerous and rarely appear before age of 60.

  4. jo says:

    Hello,
    Im 30 i and i have been diagnosed with multiple polyps on gallbladder.
    I have been refereed for gastroscopy. Doctor didnt explain why so i was wondering why?

  5. Amy Morse says:

    Hi I am a 25 year old female. I recently had started to have somewhat severe pain that wouldn’t make me stop and take a moment till it passed. This happened for about a couple months before I decided to get things checked out. Turns out I have a 8.6 mm polyp in my gallbladder with no accompanying stones or other polyps. I’m assuming the polyp although most are asymptotic mine is causing me pain. How likely is it that it’s cancerous? I feel that with my age and the pain and larger size with no other polyps or stones that I may be looking st cancer.

    • Jan Modric says:

      An experienced gastroenterologist can better answer this. Most cancerous polyps are larger than 10 mm, but some smaller ones might be cancerous as well. Some polyps that are located near the gallbladder neck can block the bile flow out of it and thus cause temporary pain. Pain from cancerous polyp would be constant.

  6. patel ravi m says:

    in ctmri
    gallbladder appear distended and shows few hyper dense non-enhancing polyps attached to gallbladder wall largest polyps measure approx 6×6 mm along inferior wall of gallbladder
    no definite evidence of adjacent gallbladder wall thickening or peri-gallbladder free fluid.
    some slightly pain in Upperback side and abdomen.please give advice and allopathic or ayurvedic medicine.please reply

  7. Khawar says:

    Yesterday with ABDOMEN Ultrasound a non mobile echogenic focus without posterior acoustic shadowing measuring 2.1 mm in size was seen adherent to the posterior wall of my gallbladder, what does it mean, how should I proceed with the treatment of this. What could be the best treatment??? Should I further repeat some other lab test to further investigate……I am worried…please guide me in detail.

    • Jan Modric says:

      This sounds like a small gallbladder polyp, which usually, at this size, is not dangerous and is very unlikely cancerous. I’m not aware of any treatment for this. To remove such polyp, a doctor would need to remove the entire gallbladder.

  8. Kit howell says:

    Does apple juice can help curing gallblader polyps???

  9. Kit howell says:

    I get ultrasound last week and the result said i have gallblader polyps..how can i cure this one

  10. I had an altar sound done. I have a polyp just a little over a cm. 1.1. The doctor doesn’t seem to be concerned. I get a lot of pain in that area. Tenderness in stomach and feel nauseous at time. Don’t feel like eating at times. And can sleep at night. Should I be worried.

    • Sorry that was ment to say can’t sleep. Due to I worry about it. I can feel something there in my side all the time. I feel I’m emotionally tired and drain from it. I can’t get in to see a specialist til 3 months

      • Jan Modric says:

        I strongly recommend you to insist in having further investigations as soon as possible and NOT waiting for 3 months. Nausea, loss of appetite and tenderness in the gallbladder area are not normal.

  11. sohan says:

    i received ultra sound report for my gall bladder. they said the below thing:
    ” A 5 mm polyp versus sludge ball is seen within the gallbladder lumen. There is no evidence for calcified stone or cholecystitis.”

    What should i understand what type of polyp is it?

    • Jan Modric says:

      To me, it sounds that the doctor thinks it is either a fleshy polyp or a clump of dense bile (sludge ball). A sludge ball may (or may not) develop into a gallstone.

      • sohan says:

        Thanks Jan. Question: what do you mean my fleshy polyp? is it consider under adenomyometosis?

        • Jan Modric says:

          By a fleshy polyp I mean an overgrowth in the gallbladder wall that projects into the lumen…as opposed to a sludge ball, which develops from the bile and subsequently get attached to the wall and looks like a polyp. It is a pathologist who can say which exact type of the polyp it is – after gallbladder removal.

  12. Mouse says:

    My close friend diagnosed with 5 mm polyp and does not have any gallstones. Is it true that if you have single polyp -it means is more chance to be having cancerous?

    • Jan Modric says:

      I wouldn’t know that…The risk of cancer increases with the polyp size. Polyps under 10 mm are not likely cancerous.

  13. Sunny says:

    I had small gb polyp 4mm in the neck of gb but I don’t have any pain yet what should I do surgery is necessary or it dissolve by medicine.I consult with doctor he said to me keep medicine for 3 months and avoid fried food.what should I do now

  14. Angela says:

    I had small Gb polyp 4mm, cause of that i feel sharp pain in my upper Abdomen ,back & on My side ,what should i do to reduce the pain and is surgery is necessary or it dissolve by any medicine.

    • Jan Modric says:

      Small polyps unlikely cause pain or any other problems. You may want to ask a doctor if you have gallstones. There are several non-gallbladder related causes of right upper abdominal pain, one of them is trapped gas, for example.

  15. Siddharth Tamang says:

    I had a growth of 4.7 mm polyp is it harmful
    .

    • Jan Modric says:

      Polyps tend to grow and a doctor can say at which point the gallbladder needs to be removed. 4.7 mm by itself is not considered dangerous but a doctor can tell.

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