Gallbladder Polyps

A gallbladder polyp is a small growth that projects from the inner wall of the gallbladder into its hollow centre.
Polyps are usually found by chance, on an ultrasound scan done for tummy pain or for a completely different reason.
Most “polyps” seen on scans are not true growths at all.

There are three main kinds:

• Cholesterol polyps — the most common. Tiny deposits of cholesterol in the gallbladder wall. They are not tumours, cannot turn into cancer, and are harmless
• Inflammatory polyps — small areas of long-standing irritation in the wall
• True growths (adenomas) — uncommon. These are the ones we watch carefully, because a true growth can, rarely and slowly, change over years

Usually not. The great majority of polyps are silent.
When a person with polyps has upper tummy pain, the pain is far more often explained by gallstones — which frequently exist alongside polyps — than by the polyp itself.
This matters, because it changes the treatment: the plan for a polyp depends on its size and type, while pain from stones is treated on its own merits.

Gallbladder cancer is rare, but it is serious, and a small number of cancers begin in a true polyp.
Size is the simplest warning signal: the bigger a polyp, the more likely it is to be a true growth rather than a harmless cholesterol deposit.
The whole management plan — watching versus removing — is built around the size of the polyp and a short list of personal risk factors. These thresholds come from the joint European guideline on gallbladder polyps, used internationally.

• Ultrasound scan: the main test. It measures the polyp in millimetres and notes whether it is single or multiple, whether it hangs on a stalk (pedunculated) or sits flat and broad-based (sessile), whether the gallbladder wall next to it is thickened, and whether stones are present
• A repeat or specialist ultrasound, if the first pictures are unclear
• An MRI scan, occasionally, when the pictures remain uncertain
• Blood tests, if there are symptoms or other concerns

These are guidelines, not rigid rules. Your surgeon weighs the size together with your age, your other health conditions, whether stones are present, and your own preference.

Surveillance is an active plan with dates attached — not “go away and forget it.”

• A repeat ultrasound at about 6 months, then at about 1 year and 2 years, in most plans
• If the polyp is unchanged and you have no risk factors, you can usually be discharged from follow-up
• If the polyp grows — by 2 mm or more, or reaches 10 mm — the conversation changes to surgery
• Surveillance only works if the appointments are kept; put them in your calendar the day they are agreed

Is my polyp a cancer?

Almost certainly not. Most polyps are cholesterol deposits that can never become cancer. The size-based plan exists to catch the rare true growth early, while it is still curable by simply removing the gallbladder.

Can diet or medicines make a polyp shrink or disappear?

No proven diet or medicine removes gallbladder polyps. Cholesterol polyps sometimes vary a little between scans, but they need no treatment. Bile-acid medicines used for some gallstones do not treat polyps.

What if I do nothing at all?

For a small polyp, “doing nothing” without appointments is different from surveillance. Surveillance is the safe version of waiting: the polyp is measured on a schedule, and surgery is offered the moment it crosses a threshold. Skipping follow-up loses that safety net.

I also have gallstones. Does that change things?

It can. Stones raise the priority for surgery at smaller polyp sizes, and if the stones themselves are causing attacks of pain, gallbladder removal is usually advised for the stones alone.

Being told you have a “growth” in your gallbladder sounds alarming — but in practice, a gallbladder polyp is usually an innocent scan finding with a clear, measured plan.
Small ones are watched on a schedule; larger ones are dealt with by a routine keyhole operation.
Either way, you leave with a plan and dates, not with uncertainty.