Diarrhea while treating for Hepatitis C

[BradT]

I am 3 months into therapy with PEG-Intron and Rebutol (combination therapy for Hepatitis C).  While I have had loose stools for decades, after taking the interferon for a couple of months chronic diarrhea began.  Dr. said to use metamucil and back off milk products, but the condition only changed from total liquid to clumps with a yellow fluid.  Dr. suspected liver bile and has prescribed cholestyramine.  Cholestyramine seems to have effect of eliminating yellow fluid and firming up stools.

Question: Will this condition resolve once interferon therapy ends and is it indicative of gallbladder disease?

[Kevin Pho, MD]

Erin, PA has kindly addressed your question in her comments below and I agree with her assessment.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[GI.PA]

Come on over to the Hepatitis board where you will find many a folks on treatment dealing with every imaginable side effect.

Diarrhea on Hep C treatment is a known sided effect, clinically seen about 5% of the time.  It might be a good idea for your doctor to make sure you dont have an infection (related or unrelated to treatment..a simple round of stool tests can do this).  In addition, treatment can cause thyroid problems, which can cause diarrhea, so this can be tested for with a simple blood test.  

As long as the Cholestryramine is keeping things under control and you are not having an other red flags (bleeding, weight loss, loss of control, significant abdominal pain), then more aggressive work up could be persued after treatment is over in a few months.  After treatment is over, if the diarrhea resolves, no big deal (unless you are over the age of 50 anyhow...and then a colonoscopy is indicated for screening alone).  If it doesnt, then a more intensive work-up (including a colonoscopy with biopsies and some more labs) may be indicated.

If the Cholestyramine isnt cutting the mustard anymore, talk to your doctor and perhaps a trial of Lomotil may be indicated.  Make sure they keep thier radar on for non-treatment related things as well.

Erin
Gastroenterology Physician Assistant