Diseases

Gallbladder polyps – causes, symptoms & treatment

Gallbladder polyps

Gallbladder polyps are usually benign tumors, which in many cases are completely symptom-free and are therefore often discovered only by chance during an ultrasound examination. Smaller polyps usually do not require therapy, but should be monitored regularly by sonography. For findings from a size of ten millimeters, however, the (usually laparoscopic) removal of the entire gallbladder is recommended, since larger gallbladder polyps have the rare risk of degeneration into carcinoma.

What are gallbladder polyps?

Gallbladder polyps are among the mostly benign tumors of the gallbladder, which are often discovered only by chance during routine ultrasound examinations due to their frequent lack of symptoms.

Not infrequently, the gallbladder polyps contain cholesterol in addition to mucosal cells, which may make them difficult to distinguish from gallstones in sonographic diagnostics. They usually only become medically relevant from a size of about ten millimeters or a rapid growth tendency.

In these cases, due to the risk of (rare) degeneration of the polyps into a carcinoma, it will be decided to remove the entire gallbladder as a precaution with the subsequent histological examination of the tissue. Approximately one in twenty – men more likely than women – is confronted with gallbladder polyps in the course of their lives.

Causes

One of the main causes of gallbladder polyps is – comparable to the typical gallstone – an increased content of cholesterol in the bile. In addition to deposits on the mucous membrane of the gallbladder (cholesteatosis), this also causes cholesterol-containing protrusions of the mucosa, the so-called cholesterol polyps.

Interestingly, stones and polyps almost never form together in the same gallbladder – in most patients, only one of the two structures is diagnosed. Since in both cases an oversupply of cholesterol leads to the development, a faulty diet must also be considered as the primary cause.

Other growths in the gallbladder can also promote the formation of polyps. As a rule, they are benign adenomas that develop either from the mucous membrane of the gallbladder or from glandular tissue (cystadenomas) and contribute to the development of gallbladder polyps.

Symptoms, complaints & signs

Gallbladder polyps often remain symptom-free or cause symptoms similar to gallstones. These are benign growths on the gallbladder, which in rare cases also degenerate malignantly. It has been observed that people who suffer from gallstones do not develop bile polyps.

Conversely, gallstones do not form in patients with biliary polyps, whether without or with symptoms. Whether gallbladder polyps cause discomfort depends on the size of the polyps and the stage of development of the disease. Isolated gallbladder polyps often show no symptoms. However, if they occur in connection with other diseases, there may be nauseavomitingpain in the right upper abdomen with radiation to the shoulder girdle, bloatingflatulence and colic.

These are complaints that can also occur in a similar way with gallstones. With extensive polyp formation, bile ducts and vascular supply can also be blocked. Occlusion of the bile duct leads to jaundice, which is noticeable by yellowing of the skin and eyes. Furthermore, it comes to excruciating itching and fatigue.

Liver function can be impaired to such an extent that its detoxification function fails. Toxic metabolic products then accumulate in the body. After removal of the affected gallbladder, the symptoms usually disappear completely. At the same time, this also eliminates the risk of degeneration of gallbladder polyps into gallbladder cancer.

Diagnosis & course

Diagnosis of gallbladder polyps is carried out by sonography, although the difference between cholesterol-containing polyps and gallstones is not always clear due to the similar appearance on ultrasound.

It is also possible to overlook the gallbladder polyps – on the one hand, if they are still very small, on the other hand, because they often cannot be sufficiently separated from the surrounding tissue structures. Some laboratory values (gamma-GT, alkaline phosphatase) can also confirm the suspicion of an event in the gallbladder.

Oft bleiben von Gallenblasenpolypen Betroffene komplett schmerzfrei, vor allem in Verbindung mit weiteren Gallenerkrankungen sind jedoch Symptome wie Schmerzen im rechten Oberbauch, die in die Schulter ziehen können, Übelkeit und Verdauungsbeschwerden möglich.

In Kombination mit anderen Störungen (Stein, Tumor) können Polypen über eine Stauung des Gallenflusses eine Gelbsucht auslösen. Bei größeren Gallenblasenpolypen muss zudem immer auch das – wenn auch eher seltene – Risiko einer Entartung in ein Karzinom bedacht werden.

Komplikationen

In der Regel kommt es durch die Gallenblasenpolypen selbst nicht zu Beschwerden, Schmerzen oder Komplikationen. Aus diesem Grund bleiben die Polypen auch sehr lange unentdeckt und werden in den meisten Fällen nur zufällig diagnostiziert. Sie können allerdings in Zusammenhang mit anderen Erkrankungen der Gallenblase zu Schmerzen oder zu einer Übelkeit führen.

Nicht selten treten auch Beschwerden bei der Verdauung oder Durchfall auf. In einigen Fällen tritt eine Gelbsucht auf. Die Behandlung findet aus diesem Grund nicht in jedem Falle statt. Sollten die Gallenblasenpolypen relativ klein sein und nicht zu Beschwerden oder zu Schmerzen führen, werden diese in der Regel auch nicht entfernt.

Dabei treten für den Patienten keine weiteren Komplikationen auf und die Polypen führen nicht zu Folgeschäden. Sollten die Gallenblasenpolypen allerdings groß sein und sich ausbreiten und wachsen, so muss in den meisten Fällen die komplette Gallenblase entfernt werden. Der Betroffene erleidet dabei einen relativ starken Gewichtsverlust und klangt über ein allgemeines Krankheitsgefühl. Es kommt außerdem zu einem erhöhten Krebsrisiko beim Patienten. Weiterhin treten allerdings keine besonderen Komplikationen auf.

When should you go to the doctor?

Gallbladder polyps often go unnoticed by the patient because they are often symptom-free. They are usually only noticed during a check-up with an ultrasound. It is therefore generally advisable to have a check-up carried out by a general practitioner at regular intervals . Routine screening helps with early detection and should be used by people of all ages. In addition, a doctor should be consulted as soon as discomfort occurs in the vicinity of the abdominal region.

If pain or discomfort occurs repeatedly, it is advisable to have these indications clarified by a doctor. A doctor should be consulted if you experience nausea, vomiting or a feeling of pressure in your chest. If there is reduced performance, an increased need for sleep or exhaustion despite adequate sleep at night, these observations should be discussed with a doctor.

In the case of changes in digestion, a doctor’s visit is necessary as soon as the symptoms persist for several days or increase in intensity. Repeated diarrhea, constipation or an intestinal blockage are causes for concern and should be evaluated medically.

Medical help can also be sought if the person concerned has a vague feeling of illness or feels an inner restlessness. If there is a feeling of tightness in the chest or if there are unusual weight changes, a doctor should be consulted.

Treatment & Therapy

Gallbladder polyps that are small and asymptomatic can be left in the gallbladder without further therapy, provided regular sonographic monitoring is carried out.

If the gallbladder is growing rapidly and is generally larger than about ten millimeters, it should be completely surgically removed (cholecystectomy). In uncomplicated cases, this is usually done very gently as part of a laparoscopy . For the patient, who does not suffer any major limitations as a result of the loss of the gallbladder, neither the operation nor the time after the operation is usually a difficult burden.

In the case of symptoms such as frequent digestive disorders, chronic fatigue or unwanted weight loss , degeneration into a precancerous stage or carcinoma must also be considered, despite the relatively rare occurrence.

If there is a suspicion of advanced disease, an abdominal incision (laparotomy) can also be operated on, as this also gives the doctor a good intraoperative exploration of the abdominal cavity and thus the extent of the disease that has developed at the bottom of a gallbladder polyp.

Outlook & Forecast

The prognosis for gallbladder polyps depends on the stage of the disease and the size of the polyps present. Basically, a gallbladder polyp is benign and has a good prognosis. The tissue changes can be completely removed in a routine operation. After the wound has healed, the patient is discharged from the treatment free of symptoms.

The larger the resulting gallbladder polyps, the more likely it is that the disease will progress to malignancy. This greatly worsens the prognosis for the patient. If left untreated, there is a risk that the symptoms will steadily increase and the general state of health will deteriorate continuously.

In addition, there is a risk of the patient dying prematurely. Cancer cells develop and can spread throughout the body to metastasize elsewhere. Early diagnosis and treatment of gallbladder polyps is therefore crucial for the further course.

Although there is usually a speedy recovery after removal of the tissue lesions, the patient can be exposed to the formation of new polyps at any time. In the course of life, a new outbreak of the disease is possible with the same prognosis. If the gallbladder polyps are in hard-to-reach places, the likelihood of complications during the procedure is possible. Damage to the surrounding tissue can occur, lead to a delay in healing or impairments.

prevention

No specific form of prophylaxis is known for gallbladder polyps. However, as some polyps contain cholesterol, as is the case with gallstones, a conscious and healthy diet can have a positive effect, at least by reducing the cholesterol content in the bile.

There is an important method of prevention with regard to the possible degeneration of gallbladder polyps into carcinomas: if small polyps have already been diagnosed, they should be checked regularly. From a size of about ten millimeters, gallbladder polyps including the bile should be removed prophylactically.

You can do that yourself

In everyday life, the patient should take care to permanently lower his cholesterol level through his food intake. A change in diet is important for this. The consumption of animal fats should be reduced or avoided.

On the other hand, foods such as tomatoes, nuts, whole grain products, garlic , onions or leeks are helpful . These should be used more when preparing meals. The consumption of fruit and vegetables should be increased overall. In addition, foods containing soy or tofu support the health of those affected.

When it comes to fluid intake, excessive consumption of coffee should be avoided. Mineral water or green tea help to relieve the symptoms. Products such as butter, sausage, cream, meat, eel, fatty smoked fish, and margarine can raise cholesterol levels. They should be removed from the diet or greatly reduced.

In addition to changing diet, the patient can take some measures to stimulate the metabolism. Sufficient exercise, regular sporting activities and avoiding nicotine or alcohol promote health and support the recovery process.

If symptoms such as nausea or dizziness occur, the patient should take it easy and allow sufficient rest periods. Overexertion is to be avoided. The needs and possibilities of the organism should be taken into account in all activities so that there is no deterioration in health.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.