Polyps in Gall Bladder

I had an ultrasound done last week and all came back fine except a small note that there were small polyps seen inside on my gall bladder. The doctor told me that in most cases these are normal and nothing to worry about as I had never felt any pain or anything else. I asked the doctor if these could be fixed and he said that nothing can be done about them and I would have to live with these. He also asked me to do another ultrasound after 1 month which I think he is doing to check the health of my gall bladder as a routine checkup.

Now I have a couple of questions. If due to any reason these polyps get larger and become a concern will there be any symptoms that will indicate that it is time to take notice like pain etc. or do I have to keep doing ultrasounds after every 3/6 months to check the health of my gall bladder for the rest of my life. Also, is there any danger of doing lots of ultrasounds. I am pretty worried and would appreciate some input on this issue.

[J.M. Keyes, MD]

Gallbladder polyps are a common incidental finding on abdominal ultrasound. They are present in an estimated 4-8% of the population. 95% are benign polyps (mostly cholesterol polyps) with no malignant (cancerous) potential. The concern is that there is a extremely small number of polyps that are malignant, and there is concern about polyps potentially becoming cancerous over time.
Polyp size seems to be the best distinguishing feature between benign and possibly malignant, with 1 cm being the accepted cut-off — larger lesions have a greater risk of being neoplastic.
Controversy exists, but most recommend follow-up ultrasound at six months or one year intervals for polyps 5 mm or larger discovered incidentally. Most will show no change in size over the years, and then the follow-up interval can be adjusted accordingly or stopped altogether. You should talk to your current physician about their regular practice for this.
Patients with gallbladder polyps larger than 1 cm generally should be referred for surgical consultation.  Surgery is also often done for someone with polyps and symptoms such as pain related to your gall baldder.  You also have the option to ask for surgical consultation if you are not agreeable to the standard of care and wish to have your gallbaldder taken out anyway, but you must be aware that surgery and general anesthesia probably pose a higher risk than the polyps if done unnecessarily.
Please speak with your physician further about your options and make sure you follow up as necessary.  
Best of luck.
JMK MD