What is Gallbladder Polyp?
Gallbladder polyps are conditions that appear as bumps extending into the open space inside the gallbladder. These polyps don’t always cause symptoms, but could be linked to discomfort in the upper right side of the belly, nausea, and being unable to eat certain foods, which are all signs of a condition called cholecystitis. Often, gallbladder polyps are discovered by chance during an ultrasound or CT scan, or are found unexpectedly when examining the gallbladder under a microscope during a medical procedure. These polyps could either be genuine growths, known as neoplastic growths, or they could be balls of cholesterol, known as pseudopolyps, clinging to the gallbladder wall.
What Causes Gallbladder Polyp?
When small growths, known as gallbladder polyps, form in the gallbladder, there are usually some underlying factors at play. Some studies suggest that conditions such as familial polyposis (a genetic disorder characterized by the growth of many polyps in the colon and rectum), Peutz-Jeghers (a genetic disorder that leads to the growth of polyps in the digestive tract), Gardner’s syndrome (another genetic disorder that can lead to a variety of growths and tumors), or having had hepatitis B can all contribute to gallbladder polyp formation.
On the other hand, some gallbladder polyps aren’t actually true polyps, but rather clumps of cholesterol or bile salts referred to as pseudo or cholesterol polyps. These can develop when there’s too much cholesterol or bile salt in the gallbladder. This can lead to clumps of cholesterol sticking to the gallbladder wall, which could later lead to the formation of gallstones. This condition can also occur alongside gallstones.
Common factors associated with gallbladder disease, such as obesity, gender, weight loss, and diabetes, have not been shown to increase the risk of developing gallbladder polyps.
Risk Factors and Frequency for Gallbladder Polyp
The causes leading to a higher occurrence of gallbladder polyps are not clearly understood. Research suggests that between 4% to 7% of the population might develop these polyps. Usually, they are diagnosed around the age of 49. However, other studies have discovered that older patients are more likely to have gallbladder polyps.
Signs and Symptoms of Gallbladder Polyp
Most people with gallbladder polyps don’t have any symptoms. However, some people with certain types of gallbladder conditions, like sluggish gallbladder function, cholesterol build-up, or stasis, may experience signs of chronic gallbladder inflammation. These can include frequent upper right abdominal pain, difficulties digesting certain foods, feeling bloated, and feeling nauseous. One common sign is the Murphy’s sign, which is pain in the upper right abdomen when it’s deeply touched. People with larger abnormal growths may experience more severe and consistent pain in the upper right abdomen. In rare cases where the polyps turn into cancer, signs could include yellowing of the skin and whites of the eyes (jaundice), due to the mass putting pressure on the common or liver bile duct, or a lump that can be felt in the upper right abdomen.
- Frequent upper right abdominal pain
- Difficulties digesting certain foods
- Feeling bloated
- Feeling nauseous
- Pain when the upper right abdomen is pressed deeply (Murphy’s sign)
- More intense and consistent upper right abdominal pain (for larger abnormal growths)
- Yellowing of the skin and eyes (jaundice) when cancerous
- A lump that can be felt in the upper right abdomen when cancerous
Testing for Gallbladder Polyp
Gallbladder polyps are often discovered by chance during imaging tests like a stomach CT scan or an abdominal ultrasound. These are commonly used when patients are being tested for gallbladder disease. Polyps, which can appear as a single growth or multiple ones, can show up with gallstones or without them. It’s important to tell the difference between gallstones and polyps. Gallstones usually move around, while polyps stay attached to the wall of the gallbladder.
Most polyps are less dense and smaller than one centimeter in diameter. They can look like mini mushrooms growing out of the gallbladder wall, or they can appear to be attached directly (like a barnacle attaching itself to the side of a ship). Single polyps that are denser than normal tissue and larger than one centimeter can have a higher chance of turning into cancer.
Treatment Options for Gallbladder Polyp
Gallbladder polyps are growths or lesions that develop inside the gallbladder. They might seem scary, but if they appear to be pseudo or cholesterol polyps (which are typically non-cancerous) and the patient has no symptoms, there’s no immediate cause for concern. Doctors usually monitor these polyps with yearly gallbladder ultrasounds. These types of polyps rarely turn into cancer.
If the ultrasound shows that the polyp is getting bigger, or if the patient starts to feel symptoms, then it might be necessary to remove the gallbladder. This removal procedure is called a cholecystectomy. Similarly, patients experiencing symptoms of chronic cholecystitis – which is a long-term inflammation of the gallbladder – are often best treated with a cholecystectomy. The procedure can either be done with minimally invasive (laparoscopic) surgery or with a traditional open surgery.
For larger polyps that are 1 cm or greater in size, removing the gallbladder is usually recommended because these larger polyps carry a higher risk of becoming gallbladder cancer. Acting early here makes a big difference. Early-stage gallbladder cancer is much easier to treat and cure compared to a more advanced cancerous lesion. For instance, people diagnosed with the earliest stage of gallbladder cancer have an 80% chance of surviving for at least five years, while chances drop to under 50% if the disease is caught at stage 1. The unfortunate truth is, less than 10% of all gallbladder cancers are diagnosed this early.
If gallbladder cancer has advanced, the cholecystectomy procedure becomes more complex. An open surgery may need to be performed, and it often involves removing a part of the liver (the gallbladder fossa) and the nearby lymph nodes along with the gallbladder.
What else can Gallbladder Polyp be?
Here are some potential issues that could affect the gallbladder:
- Adenomyomatosis (a non-cancerous disease leading to enlargement of the gallbladder wall)
- Biliary sludge (a mix of particles that develops in the bile)
- Gallstones (hardened deposits in the gallbladder)
- Gallbladder carcinoma (cancer of the gallbladder)
- Gallbladder metastases (cancer that has spread to the gallbladder from other parts of the body)
- Tumefactive sludge (a condition where the bile in the gallbladder forms a tumor-like mass)
