Your gallbladder is a small organ that stores bile after your liver produces it. Gallbladder releases bile into your small intestine. Bile contains salts, cholesterol, fat, and pigments. Gallbladder polyps are abnormal growths that stick out from the lining of the inside of your gallbladder. In 95% of cases, these polyps are noncancerous.
What Are Gallbladder Polyps?
Gallbladder polyps are abnormal growths inside the gallbladder, the small organ in the upper right abdomen that stores digestive bile. Inflammation, cholesterol, abnormal cell growth, and, in rare cases, cancer can cause them to form.
How common are gallbladder polyps?
They’re fairly uncommon and affect about 3%-6% of the general population.
“True gallbladder polyps, which are protrusions from the inner gallbladder lining and not some artifact that mimics the looks of a polyp, are probably found 8%-10% of the time by ultrasound imaging,” says Edward Lin, chief of GI and General Surgery at Winship Cancer Institute of Emory University, Emory University School of Medicine.
That’s about 1 out of 10 patients finding a polyp in their gallbladder ultrasound, Lin says.
What Causes Gallbladder Polyps?
It isn’t clear what causes gallbladder polyps. Your gallbladder is a pear-shaped organ located beneath your liver. It stores and concentrates bile from your liver.
Your body uses bile to break down and absorb fat. Your gallbladder releases it into the first section of your small intestine. Bile contains bile salts, cholesterol, fat, and bile pigments.
There may be a connection between gallbladder polyps and the way your body breaks down fat. You may be more likely to get gallbladder polyps if your body doesn’t break down fat well.
Some suggest that polyps are a response to chronic inflammation of the gallbladder.
Types of Gallbladder Polyps
Gallbladder polyps are classified as benign or malignant. Benign means the polyp is noncancerous or not harmful on its own. Malignant means it is cancerous. There are several types of gallbladder polyps.
Cholesterolosis and pseudopolyps. Pseudopolyps are the most common type of gallbladder polyp. They are not true growths and don’t develop into cancer. They’re deposits of cholesterol caused by a condition called cholesterolosis.
“[Cholesterol polyps] probably make up anywhere from, I would say, three quarters to 85% of most polyps.” says Waseem Ahmad, a gastroenterologist at University of California, San Francisco.
Pseudopolyps may point to gallbladder disease such as chronic cholecystitis. Cholecystitis is an inflammation of your gallbladder.
Inflammatory polyps. Inflammatory polyps are often linked to inflammation of the gallbladder wall. These are often found in people who have had repeated episodes of cholecystitis and acute biliary colic. This happens when a gallstone blocks a bile duct. Inflammatory polyps don’t develop into cancer.
Adenomatous polyps. These polyps are true tumors. They are rare and often occur in people who have had gallstones. They can range in size from 5 to 20 millimeters or over. Polyps larger than 1 centimeter have a greater chance of developing into cancer.
Adenomyomatosis. This type of polyp is more common as you age. Though once considered a precancerous lesion, it’s now seen as a benign change to the gallbladder due to swelling or gallstones. Only one of these polyps is usually found at a time.
Malignant polyps. This type of polyp is often larger than 2 centimeters in diameter. It is very rare. Again, only one is typically found.
“Very large polyps, say greater than 20 millimeters [2 centimeters], require more aggressive surgery where a portion of the attached liver is removed with lymph node sampling,” Lin says.
What Are the Symptoms of Gallbladder Polyps?
Gallbladder polyps often happen with no symptoms. They are usually found when your doctor does a CT scan or ultrasound for another reason. There is no difference in the symptoms of benign and malignant polyps.
But you may have symptoms that could point to gallbladder disease, such as:
- Nausea
- Vomiting
- Upper right abdominal pain
- Indigestion
Can gallbladder polyps cause pain?
If you have pain in the upper right abdomen, it’s likely that something other than a gallbladder polyp is causing it.
“Gallbladder polyps very seldomly cause pain,” Ahmad says. “If they get large enough and depending on their location within the gallbladder -- for example, if a polyp gets close to the neck of the gallbladder -- they can potentially cause some discomfort. But typically, most gallbladder polyps are very small.”
What are the risk factors of gallbladder polyps?
You’ll have a higher risk of getting a gallbladder polyp if you have high cholesterol, as the most common type of gallbladder polyps result from cholesterol buildup.
If you have a medical condition that makes it more likely that you’ll get polyps in your gastrointestinal tract, you’re also more likely to have a gallbladder polyp.
Also, you might have a higher risk of getting a gallbladder polyp if you have gallstones, gallbladder inflammation, chronic bile duct inflammation, or hepatitis B, or are over 50 years.
“For the routine person that is incidentally found to have a gallbladder polyp, I would say it’s something not to lose sleep on, as long as there’s routine surveillance,” Ahmad says.
How Are Gallbladder Polyps Diagnosed?
Gallbladder polyps are normally hard to diagnose because there often aren’t any symptoms. You’re more likely to discover you have a gallbladder polyp while getting tested for another medical concern, in what’s called an “incidental finding.”
“For gastroenterologists in clinic, we see a lot of patients for abdominal pain, abdominal bloating, altered bowel habits, and that ends up leading to work-up — including getting imaging scans to assess for those conditions,” Ahmad says. “And incidentally, on either an ultrasound or a CT scan, will we find a gallbladder polyp. But usually we’re not seeking out gallbladder polyps as the main source of symptoms.”
Tests for gallbladder polyps
Rather than running a test to figure out if you have a gallbladder polyp, your doctor will likely find it accidentally through an abdominal ultrasound or CT scan. In rarer cases, an MRI scan could show a gallbladder polyp.
“It would not be something that would be picked up on just a routine upper endoscopy that gastroenterologists often do for other GI work-ups,” Ahmad says.
Can gallbladder polyps be cancerous?
“The majority of gallbladder polyps are not cancerous, and if they are left alone, probably nothing would happen, because most of them are asymptomatic,” Ahmad says.
But about 5% of gallbladder polyps are cancerous and would need more medical attention.
How fast do polyps grow in the gallbladder?
“Typically, it’s a slow process,” Ahmad says. “Most polyps, if they’re small, actually will not grow that fast. With a little bit of surveillance or yearly imaging, if things are stable, then we actually just stop doing imaging.”
“Going forward, however, if the polyp is found at a certain size — which for us, is typically 6 millimeters — and if we do a follow-up ultrasound and it has increased in size, then sometimes we do get worried that potentially it will increase to a size that may represent either symptoms down the road or be a cancer potential down the road,” Ahmad says.
How Are Gallbladder Polyps Treated?
Treating your gallbladder polyp will depend on its size and the presence of symptoms. Often, small gallbladder polyps won’t require medical help. If they’re the size of 6 millimeters, your doctor might want to bring you in for regular checkups to make sure they’re not getting bigger.
“For the patients that do have symptoms that we suspect could be related to the polyp or if their polyp has gotten kind of big, over a centimeter, the management is actually a referral to our surgeons for a cholecystectomy, or gallbladder removal,” Ahmad says.
Can gallbladder polyps disappear with time?
Often, if you have a polyp, it won’t go away on its own. “The question is, ‘Will it progress in size or not?’ And that’s the thing that is difficult to determine, because there really is nothing lifestyle-wise that someone is doing that is going to increase or decrease that rate of polyps,” Ahmad says.
How are gallbladder polyps removed?
Although most gallbladder polyps form due to high cholesterol, cholesterol-reducing medication doesn’t appear to lower the size or growth of gallbladder polyps.
The primary way to remove a gallbladder polyp is through surgery.
Recovering from gallbladder polyps
Gallbladder polyps are fairly common and usually benign. Your doctor may recommend that you simply follow up with ultrasounds to check for changes if you don't have any symptoms from them.
Your doctor will do a surgery called a cholecystectomy if you need to have your gallbladder removed. It’s common and has a low risk of complications. You can usually go home the same day you have the surgery. But sometimes, you may need to spend the night in the hospital.
Cholecystectomies are usually done laparoscopically. This means they’re done with a small video camera and don’t involve large cuts. Your doctor will make four small cuts in your abdomen and use a camera and special surgical tools to remove your gallbladder.
You may need an open cholecystectomy if your doctor can’t do the laparoscopic one. This involves one large cut and is far more invasive. It also has a greater risk of infection. You may need to spend two or three days in the hospital to get better.
Recovery from a laparoscopic cholecystectomy usually takes about one week. Full recovery from an open cholecystectomy can take four to six weeks.
If there are particularly large polyps, more than just the gallbladder may need to be removed. “Large polyps usually involve the removal of the liver wrapping around the gallbladder, and the invasiveness will determine the outcome,” Lin says.
Risks for Malignant Gallbladder Polyps
Malignant gallbladder polyps are rare. But some factors can raise your risk of them. These include:
- Being over the age of 50
- Having diabetes
- The size of your polyp
- Having gallstones
- Having a single polyp
- Having a polyp with symptoms
Takeaways
Most of the time, gallbladder polyps don’t cause any symptoms and aren’t a cause for concern. Often, they’re discovered by accident during other exams. If your doctor notices you have gallbladder polyps, they will likely continue to watch them to make sure they don’t grow into something more serious. If the polyp does start to grow, your doctor may recommend removing your gallbladder.
FAQs on Gallbladder Polyps
What is the survival rate for gallbladder polyps?
“I would say it’s a very good survival rate,” Ahmad says. “I would not be overly concerned about cancer. Your survival for small polyps are typically virtually 100%.”
You can work with your gastroenterologist to figure out what kind of gallbladder polyp you have. Then, you can find if you have high risk factors for it developing into cancer.
Can you live without a gallbladder?
You can live a healthy life without a gallbladder. A small number of people who have had their gallbladder removed may experience changes to their bowel movements, such as softer, more frequent stools. This is due to bile flowing into the small intestine more often. But loose stools after a gallbladder removal can go away in time.
What should I not eat without a gallbladder?
Your tolerance for some foods may change after getting your gallbladder removed. Also, you might want to temporarily avoid greasy or spicy food after the surgery.
What are permanent issues after gallbladder polyp treatment?
Most people who have had surgical gallbladder polyp treatments don’t have any complications. A small group of people may get repeated abdominal pain after getting their gallbladder removed, which could be from nerve sensitivity post surgery. Others might have bile acid diarrhea, which is common after gallbladder removal and results from too much bile entering your intestines during digestion.
If you have diarrhea after getting your gallbladder removed, your doctor will likely try to work with you to figure out the cause.
Does a 1 centimeter gallstone need surgery?
Unlike with gallbladder polyps, there is no clear rule on whether a 1 centimeter gallstone requires surgery. You are more likely to require surgery for a 1 centimeter gallstone if your doctor thinks it may have caused a blockage, such as if you’ve experienced upper right abdomen pain and nausea.
Your doctor may more readily suggest surgery for a 3 centimeter gallstone, as it could come with a higher risk of gallbladder cancer.
How are benign gallbladder polyps treated?
Treatment for benign polyps depends on the size of your polyp. Your doctor may just want to wait and follow up with regular ultrasounds for a small polyp that isn’t causing any symptoms.
Your doctor may recommend removing your gallbladder if you have a larger polyp or if you’re having other symptoms.
