Ulcerative colitis and Hepatitis C

  Do you think it would be ok for someone who has UC and hepatitis
  C to have a colonectomy. Would the increased risk of the operation
  by prohibitive ? Otherwise would interferon therapy increase the severity
  of the UC ? Seems like removing the inflamed colon might be the only option
  Is there any precedent for such a potentially lethal combination of
  disease in your experience or those of colleagues, and how was it delt
  with.                

[HFHSM.D.-D.M.]

Dear Henry:
I really appreciated your questions though I think you have to appreciate the situation you describe is unique and I really would need more information before I could give specific advice.  However, perhaps I can say a few things that might be helpful to you.  
First of all, anyone with hepatitis C should be evaluated for the extent of their liver disease.  Most patients with hepatitis C have relatively early disease and they have livers that are functioning well.  If that is the case, a patient should be able to tolerate a colectomy without undue risk or difficulty if it is felt to be indicated.  If someone has severe liver disease or a failing liver, there is an increased risk associated with surgery, however, this level of liver disease usually becomes clear to us during the course of our evaluation.  
In answer to your other questions, I personally have not had a patient with hepatitis C and marked ulcerative colitis.  However, because both condition are relatively common, there are a variety of reports in the literature about patients with both conditions.  What I can tell you is that in some circumstances patients with ulcerative colitis who received interferon for hepatitis C had worsening of their colitis.  However, in many circumstances patients with colitis who received interferon for hepatitis C did not have worsening of the colitis.  I  think a lot of it has to do with the individual patient.  If someone has severe colitis that does not respond well to therapy, they may not be the best candidate for interferon.  However, if someone traditionally has mild colitis or colitis that has been in remission for sometime, it might be worth trying interferon or combination therapy (interferon/ribavirin) if this is felt to be indicated.  
I hope this information is helpful to you. Good luck to you or your friend.  If you have additional questions or concerns, I invite you to contact us at Henry Ford.  Our direct phone number is  [phone].   I would also encourage you to visit us at Henry Ford.  We have an active group of liver specialists and we have enormous interest in and experience with hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  

[Amyadams3]

A related discussion, Hep C and colitis was started.