A. What is gallbladder polyp
Gallbladder polyps are superfluous organisms that grow on the inner wall of the gallbladder cavity, small ones are shaped like corn only 1 mm to 2 mm, large ones resemble mulberries up to 2 cm, according to the number of polyps are divided into solitary and multiple. The pathological histology of gallbladder polyps is not all the same in nature, it has three types. The first type, cholesterol polyps, is the most common, and more than 95% of polyps belong to this type. It is formed when macrophages in the wall of the gallbladder ingest cholesterol crystals from the bile and then accumulate, often multiple polyps are present at the same time. The second type, called inflammatory polyps, is a local tissue hyperplasia formed during recurrent episodes of cholecystitis and is clinically characterized by the combination of gallbladder stones and chronic cholecystitis in most cases. The third type is adenomatous polyp, which is rare, accounting for only 0.5% of all polyps, and is usually solitary. Among the three types of polyps, it is the only real tumor lesion. Although it is a benign tumor, it may become cancerous when it increases to a certain degree.
About 5% of the population has gallbladder polyps, most of which do not cause any symptoms and are only detected by chance during ultrasound examination. A small percentage of people may experience varying degrees of right upper abdominal swelling or biliary colic, which may be caused by a polyp growing near the gallbladder duct. Polyps obstruct the flow of bile from the cystic duct, which is a very thin duct that drains bile outward, causing discomfort and pain due to increased pressure in the cavity of the gallbladder and, over time, chronic cholecystitis. Polyps combined with stones in the above performance, may be mainly related to the stones.
Second, the harm of gallbladder polyps
There are three different types of gallbladder polyps, cholesterol polyps and inflammatory polyps, which do not cause clinical symptoms and are not harmful to health and life. Adenomatous polyps are tumors that have a tendency to become malignant, and it should be said that this is the biggest potential threat. According to the current level of imaging technology, we can only generally distinguish the nature of polyps, and it is even more difficult to determine whether the polyps are cancerous in the early stage. However, adenomatous polyps are rare, less than 1% in total, and whether malignant changes occur is closely related to the size of the polyps. By summarizing and analyzing a large number of cases, we found that there are almost no malignant polyps below 1 cm, and once the polyps grow more than 1 cm, the chance of cancer increases steeply to 2%-13%, and some medical literature reports even more than 20%.
If there are recurrent episodes of discomfort or pain in the right upper abdomen, and the doctor can rule out other causes, surgery can be considered in this case. If chronic cholecystitis has developed, especially in combination with gallbladder stones, it should of course be treated. For the majority of gallbladder polyps that are found incidentally during physical examination and do not cause any symptoms, the need for treatment depends mainly on the size and growth rate of the polyps. The specific approach to the management of these polyps is: polyps of up to 5 mm are found on the first examination and are reviewed by ultrasound once a year thereafter. If the polyp is more than 5 mm but does not reach 1 cm, ultrasound examination again after half a year can be changed to annual review if there is no change in size, on the contrary, if the polyp has increased in size, close follow-up is required to shorten the interval of review. If the polyp size has reached 1 cm or larger, or if it has increased more than 3 mm during the follow-up review, cholecystectomy should be performed to exclude the possibility of cancer, and pathological histological evaluation should be done.
III. Treatment
In general, most of the asymptomatic gallbladder polyps do not require treatment, more so in case of multiple small polyps, which can be basically diagnosed as cholesterol polyps. Larger polyps need to be removed from the gallbladder, the surgery is mainly prophylactic, and most cases are still benign lesions after removal by pathology. As long as the surgery is timely, even if the polyp is already malignant, it is still in the early stage and the prognosis is good. However, surgical treatment can lead to complications such as vascular damage, organ damage, etc. Either complication may lead to serious consequences. For another, it is a treatment of the symptoms rather than the root cause, because surgery only targets the lesion, but not the causative factors, so it cannot solve the problem at the root.
In recent years, non-surgical and herbal treatment of gallbladder polyp disease has attracted widespread attention in the medical community, a variety of prescriptions, formulas, test prescriptions, etc. in anti-inflammatory, bile, control of cholecystitis, gallbladder polyps, etc. have achieved certain results, for the gallbladder polyps specialist drugs have also made great achievements, with the in-depth research of Chinese medicine, non-surgical treatment of gallbladder polyps cure rate, is also rapidly increasing. According to Chinese medicine, there are two reasons for the formation of gallbladder polyps: one is due to liver stagnation, dysfunctional drainage, Qi and blood do not run smoothly, long depression into stasis; the second is due to stagnation in the intestines and stomach, dysfunctional transportation, water and dampness within the stagnant, contained and heat, up steam liver and gallbladder, so that the liver does not drain, long depression into stasis. The yellowish coating on the tongue is due to damp-heat in the liver and spleen. The principle of treatment for this disease should be to dredge the liver and bile, clear heat and fire, and strengthen the spleen to dispel dampness.
Four, prevention
1, prohibit alcohol and alcoholic beverages
Alcohol in the body mainly through the liver decomposition, detoxification, so alcohol can directly damage liver function, causing liver and gallbladder dysfunction, so that the secretion and discharge of bile disorder, which stimulates the gallbladder to form new polyps and / or the original polyp growth, become larger, increasing the cancer factor of gallbladder polyps.
2, regular diet, breakfast to eat well
Regular diet and good breakfast are extremely important for patients with gallbladder polyps. The liver is responsible for the secretion of bile, which is stored in the gallbladder, and the function of bile is mainly to digest oily food. If you do not eat breakfast, the bile secreted at night is not used, stored in the gallbladder, bile in the gallbladder for too long, you can stimulate the gallbladder to form gallbladder polyps or make the original polyps increase, so it is best to eat some vegetable oil food for breakfast.
3.Low cholesterol diet
Excessive cholesterol intake can increase the metabolic and cleaning burden of liver and gallbladder, and cause excess cholesterol to crystallize, accumulate and precipitate in the gallbladder wall, thus forming polyps, so patients with gallbladder polyps should reduce cholesterol intake, especially at night, should avoid eating high cholesterol foods such as eggs (especially egg yolk), fatty meat, seafood, scaleless fish, animal offal and other foods.
V. Dietary precautions
1.It is advisable to eat a variety of fresh fruits and vegetables, low-fat, low-cholesterol foods such as mushrooms, fungus, celery, bean sprouts, kelp, lotus root, fish, rabbit, chicken, fresh beans, etc.
2.It is advisable to eat more dry beans and their products.
3.It is advisable to use vegetable oil, not animal oil.
4, eat less chili, raw garlic and other stimulating food or spicy food
5.It is advisable to use cooking methods of boiling, steaming, braising, stir-frying, mixing, blanching, stewing, without oil frying, deep-frying, baking, smoking cooking methods.
6, hawthorn 10 grams, hang chrysanthemum 10 grams, cassia seeds 15 grams, decoction for tea or drinking green tea.
7, usually drink water, pinch a little hawthorn, sea buckthorn, ginkgo, gibberellic acid grass into the water cup as tea.