The gallbladder stores bile and helps turn cholesterol and fats into cholesteryl esters to aid in digestion. These cholesteryl esters allow cholesterol and fatty acids to be transported through the body in the bloodstream. Cholesterolosis occurs when there’s a buildup of cholesteryl esters and they stick to the wall of the gallbladder forming polyps.
This condition is more common in adults but rare in children. The fewer incidences in children may be due to less imaging tests done on children’s gallbladders. Less imaging means that cholesterolosis may not be diagnosed due to lack of symptoms.
Cholesterolosis can be either localized or diffused. Localized cholesterolosis is when there are individual polyps. Diffused cholesterolosis means that there are groups of polyps. There may also be a number of these groups on the gallbladder wall. Diffused cholesterolosis is also called strawberry gallbladder.
Are there symptoms?
There are usually no symptoms with cholesterolosis. However, there’s some belief that it may have similar symptoms to those of gallstones.
Cholesterolosis occurs due to an unusually high amount of cholesteryl esters. One reason for this is believed to be from degeneration during the natural aging process. However, the cause of these high amounts of cholesteryl esters is still under some debate among medical professionals and researchers.
Studies haven’t shown a clear relationship between the possible causes. Some controversial suspected causes include:
- alcohol consumption
- elevated serum cholesterol levels
- elevated BMI
While scientists have been researching these as possible causes, there hasn’t been solid results confirming it. Some studies have shown that those with cholesterolosis have a higher level of saturated cholesterol in their bile. The direct cause for this higher level of saturated cholesterol is still being researched, but the result is the formation of more cholesteryl esters.
Currently, studies are ongoing to find a proven cause of cholesterolosis beyond the degenerative process of normal aging.
Treatment and management options
In most cases, you won’t know you have cholesterolosis unless you have an ultrasound or other imaging test for gallstones, or after a cholecystectomy, the removal of your gallbladder.
Because there aren’t usually any symptoms associated with cholesterolosis and the polyps are most often benign, no treatment is necessary. If your doctor does discover that you have this condition, you may have an MRI or another scan done once a year, just to keep an eye on the polyps. In some cases, your doctor may want to do a biopsy of your polyps to confirm that they’re benign.
There are some medical professionals who believe that controlling some aspects of your general health may help prevent or manage cholesterolosis. This includes:
- losing weight or keeping your BMI at a recommended level
- controlling high cholesterol
- reducing alcohol consumption
- not smoking
However, there isn’t sufficient research at this time to prove that these measures will affect your cholesterolosis. In general, though, these things are good for your overall health.
How is it diagnosed?
Cholesterolosis is usually found either during an ultrasound, MRI, or other imaging test, or after a cholecystectomy. Often this condition is discovered during imaging to diagnose gallstones.
Complications and associated conditions
There are no known complications of benign cholesterolosis. Some medical professionals believe that they increase the risk of gallstones. However, there’s no proof yet that this is the case.
The most common condition associated with cholesterolosis is adenomyomatosis because it looks very similar in some imaging procedures. However, your doctor will usually request an MRI which will make it possible to tell the difference between the two conditions.
In the uncommon case of cholesterolosis in children, it’s usually associated with other medical conditions. These conditions may include:
- Peutz-Jeghers syndrome. This condition causes noncancerous polyps to form in the gastrointestinal tract.
- Metachromatic leukodystrophy. This condition causes an accumulation of fats in cells.
- Pancreatobiliary malunion. This condition is a cause of bile duct obstruction.