• Monday May 25,2020

Gallbladder polyps

Gallbladder polyps are usually benign tumors, which in many cases run completely symptom-free and are therefore often discovered by chance during an ultrasound examination. Smaller polyps usually do not require treatment, but should be checked sonographically. However, in the case of findings as large as ten millimeters, the removal of the entire gallbladder (usually laparoscopic) is recommended, as there is a rare risk of degeneration in a carcinoma of larger gallbladder polyps.

What are gallbladder polyps?

Gallbladder polyps often remain symptom-free or cause similar symptoms as gallstones. These are benign growths on the gallbladder, which in rare cases sometimes degenerate malignantly.
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Gallbladder polyps are among the most benign neoplasms of the gallbladder, which are often discovered by chance during routine ultrasound examinations because of their frequent lack of symptoms.

Not infrequently, gallbladder polyps contain cholesterol as well as mucosal cells, which makes them difficult to distinguish from gallstones in sonographic diagnostics. They usually only gain medical relevance from a size of about ten millimeters or a fast growth trend.

In these cases, due to the risk of (rare) degeneration of the polyps into a carcinoma, it will be decided to treat the entire gallbladder with caution, followed by histological examination of the tissue. About every twentieth - men rather than women - is confronted with gallbladder polyps during their lifetime.

causes

The main causes of gallbladder polyps are - comparable to the typical gallstones - an increased content of cholesterol in the bile. In addition to deposits on the mucous membrane of the gallbladder (cholesteatosis), it also causes cholesterol-containing protrusions of the mucous membrane, the so-called cholesterol polyps.

Interestingly, in the same gallbladder, there is almost never any common formation of stones and polyps - in most patients, only one of the two structures is diagnosed. Since in both cases an oversupply of cholesterol leads to the emergence, also a faulty nutrition must be considered as a primary cause.

Other growths in the gallbladder may favor the formation of polyps. They are usually benign adenomas that develop from either the gall bladder or glandular tissue (cystadenomas) and contribute to gallbladder polyps.

Symptoms, complaints & signs

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

Conversely, in patients with gallbladder polyps, gallstones are not formed, either with or without symptoms. Whether it comes to complaints in gallbladder polyps, depends on the size of the polyps and the stage of development of the disease. Isolated gallbladder polyps often show no symptoms. But if they occur in conjunction with other diseases, it can cause nausea, vomiting, pain in the right upper abdomen with radiance in the shoulder girdle, bloating, flatulence and colic.

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

The liver function can be so impaired that its detoxification function fails. The body then accumulates toxic metabolic products. After the removal of the affected gallbladder the symptoms usually completely disappear. At the same time, it also eliminates the risk of degeneration of gallbladder polyps into gallbladder cancer.

Diagnosis & History

The diagnosis of gallbladder polyps is made by sonography, although the difference between cholesterol-containing polyps and gallstones is not always clear due to the similar appearance in the ultrasound.

An oversight of the gallbladder polyps is also possible - on the one hand, if they are still very small, on the other hand, because they often can not be sufficiently demarcated from the surrounding tissue structures. Also, some laboratory values ​​(gamma-GT, alkaline phosphatase) may confirm the suspicion of events in the gallbladder.

Often affected by gallbladder polyps remain completely painless, especially in connection with other bile diseases, however, symptoms such as pain in the right upper abdomen that can pull into the shoulder, nausea and indigestion are possible.

In combination with other disorders (stone, tumor), polyps may cause jaundice by blocking the flow of bile. In the case of larger gallbladder polyps, the risk of degeneration into a carcinoma, albeit a rare one, must always be taken into consideration.

complications

As a rule, the gallbladder polyps themselves do not cause discomfort, pain or complications. For this reason, the polyps remain undetected for a very long time and in most cases are only diagnosed by chance. However, they may cause pain or nausea in association with other gallbladder disease.

Not infrequently there are also complaints of digestion or diarrhea. In some cases, jaundice occurs. The treatment does not take place for this reason in every case. If the gallbladder polyps are relatively small and do not cause discomfort or pain, they are usually not removed.

There are no further complications for the patient and the polyps do not lead to consequential damage. However, if the gallbladder polyps are large and spread and grow, in most cases the entire gallbladder must be removed. The affected person suffers from a relatively heavy weight loss and sounds about a general malaise. There is also an increased cancer risk in the patient. However, there are no special complications.

When should you go to the doctor?

Gallbladder polyps often go unnoticed by the patient as they are often symptom free. Most of them are not noticed until a check-up by ultrasound. Therefore, it is generally advisable to have a check-up carried out by a family doctor at regular intervals. Routine screening helps with early detection and should be used by people of all ages. In addition, consult a physician as soon as complaints occur near the abdominal region.

If pain or a feeling of being unwell occurs repeatedly, it is advisable to seek medical advice. In case of nausea, vomiting or a feeling of pressure in the chest, a doctor should be consulted. If it comes to a reduced performance, an increased need for sleep or exhaustion despite sufficient nighttime sleep, these observations should be discussed with a doctor.

For changes in digestion, a visit to the doctor is necessary as soon as the symptoms persist for several days or increase in intensity. Repeated diarrhea, constipation or intestinal obstruction give cause for concern and should be medically clarified.

Medical assistance can also be used if the person concerned has a diffuse feeling of illness or feels an inner unrest. If there is a feeling of tightness in the chest or unusual weight changes, consultation with a doctor should be sought.

Treatment & Therapy

Gallbladder polyps, which are small and without symptoms, can be left in the gallbladder without further therapy, assuming regular sonographic control.

With rapid growth and generally from an extent of about ten millimeters, the gallbladder should be removed completely surgically (cholecystectomy). In uncomplicated cases this usually happens very gently in the context of a laparoscopy. For the patient, who does not suffer any major restrictions due to the loss of the gallbladder, neither the surgery nor the time after the procedure is usually a difficult burden.

In the case of symptoms such as frequent indigestion, chronic fatigue or unwanted weight loss, degeneration into precancer or carcinoma must be considered despite the relatively low frequency of occurrence.

If there is a suspicion of advanced disease, surgery can also be performed with the help of a laparotomy (laparotomy), as this additionally provides the surgeon with a good intraoperative exploration of the abdominal cavity and thus the extent of the disease arising on the floor of a gallbladder polyp.

Outlook & Forecast

The prognosis for gallbladder polyps depends on the stage of the disease and the size of the existing polyps. Basically, a gallbladder polyp is benign and gets a good prognosis. The tissue changes can be completely removed in a routine procedure. Following wound healing, the patient is released from treatment as symptom-free.

The larger the resulting gallbladder polyps, the more likely a malignant disease process becomes. Thus, the prognosis for the patient deteriorates immensely. Left untreated, there is a risk of a steady increase in symptoms and a general deterioration of the overall health.

In addition, the premature death of the patient threatens. Cancer cells develop and can spread in the organism to form metastases elsewhere. Early diagnosis and treatment of gallbladder polyps is therefore crucial for the progression.

Although a rapid recovery can usually be achieved by removing the tissue changes, the patient can be exposed to a new development of polyps at any time. In the course of life a renewed outbreak with the same prognosis is possible. If the gallbladder polyps are located in hard-to-reach areas, the likelihood of complications during the procedure is possible. Damage to the surrounding tissue may result, leading to a delay in healing or impairment.

prevention

In gallbladder polyps, no special form of prophylaxis is known. However, as with some gallstones, some polyps are cholesterol-containing, so a conscious and healthy diet can have a positive impact, at least through the reduction of cholesterol in the bile.

An important method of prevention exists with regard to the possible degeneration of the gallbladder polyps into carcinomas: If small polyps are already diagnosed, these should be checked regularly. From a size of about ten millimeters, gallbladder polyps, including bile, should be removed prophylactically.

You can do that yourself

In everyday life, the patient should pay attention by his food intake to permanently lower his cholesterol level. For a change of diet is important. The consumption of animal fats should be reduced or avoided.

On the other hand, foods such as tomatoes, nuts, whole grains, garlic, onions or leeks are helpful. These should be used more often in the preparation of meals. The consumption of fruits and vegetables should be increased overall. In addition, soy-containing foods or tofu support the health of those affected.

In the case of fluid intake, it is necessary to avoid excessive consumption of coffee. Mineral water or green tea help to relieve the discomfort. Products such as butter, cream, meat, eel, smoked fish, rapeseed or olive oil increase the cholesterol level. They are to be deleted from the nutritional plan or greatly reduced.

In addition to diet change, the patient may take some measures to stimulate the metabolism. Sufficient exercise, regular exercise and the avoidance of nicotine or alcohol promote good health and support the recovery process.

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


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