Cholesterolosis of the gallbladder happens when cholesterol accumulates in the gallbladder, forming polyps. It is often symptomless, but pain, indigestion, fever, and jaundice may occur. If so, treatment may be necessary.

Cholesterolosis does not usually cause symptoms. However, sometimes people can experience problems such as inflammation and pain. If symptoms are unmanageable, treatment for this condition typically involves surgery to remove the gallbladder.

This article discusses cholesterolosis of the gallbladder, its symptoms, diagnosis, and treatment.

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Cholesterolosis of the gallbladder is characterized by the accumulation of cholesterol on the inner walls of the gallbladder. This fat or lipid accumulation forms plaques or polyps.

The gallbladder is a small, pear-shaped sac located under the liver. Its function is to store and concentrate the bile that the liver produces. Bile is an alkaline fluid that helps break down fats in the intestine during digestion and aids fat absorption. The body excretes most cholesterol from the body into bile.

Cholesterolosis of the gallbladder may occur as localized or diffuse cholesterolosis.

Localized gallbladder cholesterolosis involves individual polyps, while the diffuse form of the condition involves groups of polyps.

Doctors may also call diffuse cholesterolosis “strawberry gallbladder.” The name comes from the stippled appearance of the tissue that resembles a strawberry when examined with the naked eye. Both forms typically do not cause symptoms.

Doctors are not sure why some people develop the condition.

Risk factors for gallbladder issues, such as obesity, sex, and diabetes, do not seem to increase the likelihood of gallbladder polyps.

Cholesterolosis of the gallbladder affects around 9–26% of people. It is uncommon in children.

Gallbladder cholesterolosis is typically symptomless.

However, if someone develops complications such as gallstones, gallbladder inflammation, or pancreatitis, they may experience abdominal pain and fever. Uncommonly, the polyps themselves can cause similar symptoms.

Due to cholesterolosis of the gallbladder being typically symptomless, doctors may find it while diagnosing other conditions or during routine physicals. They may notice the condition on an ultrasound, MRI, or CT scan.

The polyps may present as a single lesion, or there can be many. Although they can occur with gallstones, doctors typically see them on their own.

When making a diagnosis, doctors must differentiate between gallstones and gallbladder polyps. Gallstones are usually moveable and unfixed. In comparison, polyps are attached to the wall of the gallbladder. Most polyps are dense and smaller than 1 centimeter in diameter. Larger polyps are more likely to be cancerous.

Cholesterolosis of the gallbladder is usually benign and does not require treatment.

However, if someone has symptoms, doctors may opt to remove the gallbladder during an operation called a cholecystectomy.

Over 20 million people in the United States have gallbladder disease, and cholecystectomy is one of the most common surgeries for treating gallbladder issues.

People often recover quickly. However, some people may experience symptoms that resemble those of gallstones after surgery, including:

Doctors call this postcholecystectomy syndrome (PCS). Experts believe the cause is bile leaking into the stomach or gallstones left in the bile ducts. The symptoms are usually mild and short-lived.

Cholesterolosis of the gallbladder is usually benign and causes no other health problems.

However, it may lead to other conditions.

For example, a 2018 case study reported details of a 55-year-old female who developed acute pancreatitis. Doctors found that she had cholesterol polyps in her gallbladder, but there was no evidence of gallstones. The person underwent cholecystectomy to remove the gallbladder, and her symptoms resolved.

Cholesterolosis of the gallbladder may also be a precursor to gallstone formation, and sometimes people have both conditions. However, having cholesterolosis does not increase a person’s risk of gallbladder cancer.

Anyone experiencing upper abdominal pain or fever should contact a doctor immediately. A doctor can order tests to determine the cause of the symptoms and recommend treatment options.

Gallbladder problems can have serious outcomes. Acute cholecystitis is gallbladder inflammation that can happen if the cystic ducts become blocked. If left untreated, acute cholecystitis can lead to:

  • gallbladder perforation
  • sepsis
  • death

Anyone with persistent upper abdominal pain should consult a doctor to determine the cause and rule out serious conditions.

Cholesterolosis of the gallbladder is relatively common. It occurs when cholesterol deposits build up in the gallbladder, forming polyps.

Doctors are not sure why some people develop cholesterolosis of the gallbladder.

Cholesterolosis typically does not cause symptoms. Therefore, doctors may only discover the condition during routine physicals or while trying to diagnose other conditions.

Treatment is usually not necessary unless someone experiences symptoms.