Creeping Fat in Crohn’s Disease - An Insight

Introduction

Fat that accumulates in the abdomen is known as creeping fat. It conforms to the colon's walls. Chronic obesity is closely associated with Crohn's disease (it is a long-term illness that makes the digestive tract inflamed) and can exacerbate its symptoms. The fat between the abdominal muscles and the intestine's outer layer is called mesenteric fat. It encompasses the small and large intestines and runs nearly the whole colon length. Occasionally, this mesenteric fat may encircle the colon.

What Is Creeping Fat in Crohns Disease?

Mesenteric fat, which lies between the abdominal muscles and organs, is where creeping fat first appears. Beginning to resemble fingers, this fat seeps into the muscle layer around each intestine. Around the full circumference of the intestine, the fat may extend beyond halfway. Some scientists believe that the intestine and the mesenteric fat are the same in Crohn's disease. This is because the mesentery starts to join the various intestinal segments. The abundance of blood and lymph arteries in the mesenteric fat facilitates the simple movement of organisms and cells between the intestinal segments. It also makes it easier for bacteria to travel from one area of the intestines to another.

What Is Crohns Disease?

One kind of inflammatory bowel illness is Crohn's disease (IBD). It results in the tissues in the digestive tract swelling (inflammation), which can cause severe diarrhea, exhaustion, weight loss, and malnourishment. Crohn's disease-related inflammation often affects the small intestine but can affect other parts of the digestive tract in different persons. The deeper intestinal layers are frequently affected by this inflammation. In addition to being extremely painful and incapacitating, Crohn's disease can occasionally result in potentially fatal consequences.

Although there is currently no known cure for Crohn's disease, treatments can significantly lessen its symptoms and even cause an extended period of time when the inflammation is healed. Many individuals with Crohn's disease are able to lead normal lives after receiving therapy.

Does Creeping Fat Cause Crohns Symptoms?

The normal intestinal bacteria in Crohn's disease do not work properly, which makes room for opportunistic germs to proliferate. Bacteria may spread to other areas of the intestine through the creeping fat. As a result of this bacterial overgrowth, the body may create creeping fat as a defense mechanism. A bacterial illness in the intestines cannot move to other areas of the body with the assistance of the creeping fat. It has been proposed that accumulating body fat may increase intestinal inflammation.

This may cause or exacerbate symptoms of Crohn's disease, like:

• Constipation with diarrhea.

• Rectal bleeding.

• Urgent bowel movement (tenesmus).

• Stomach aches and cramps, a feeling that the bowels have not emptied.

Can Creeping Fat Cause Complications in People With Crohns?

The intestines themselves start to change as fat starts to proliferate around them. Some consequences of Crohn's disease, including the following, may be caused by creeping fat:

• Strengthened intestinal muscle walls.

• Strictures that result in blockages, fibrosis, or scarring along the intestinal wall.

• Inflammation of the intestinal wall that results in fistulas, tumors, ulcers, or abscesses.

Studies have indicated that creeping fat may contribute to various alterations in the colon wall's connective tissues. Among them are:

• Hypertrophy: Heightened muscle expansion in the colon wall.

• Fibrosis: Fibrosis, is an excessive buildup of scar tissue in the colon's wall.

• Colon narrows as a result of stricture development.

These modifications to the colon wall's stricture may also impact Crohn's disease symptoms. Blocked colons can also result from the accumulation of scar tissue and structures. Some of the following symptoms could be present in an individual with a blockage:

• Stomach pain.

• Nausea.

• Vomiting.

• Bloating (the incapacity to expel gas and excrement).

What Are the Risks of Developing Creeping Fat in Crohns Disease?

Increases in visceral fat, or the fat around organs located deeper in the stomach, are the primary cause of creeping fat. Obesity and visceral fat are frequently associated, while some individuals with an ordinary body mass index may have elevated visceral fat. Moreover, inflammatory bowel disease (a collection of inflammatory diseases affecting the small intestine and colon) also increases the chance of creeping fat.

How to Treat Creeping Fat in Crohns Disease?

The Crohn's and Colitis Foundation states that there are no specific treatments for creeping fat. They add that creeping fat did not appear to alter after receiving anti-inflammatory therapy. Doctors treat inflammation with drugs called anti-tumor necrosis factor (TNF) therapy. On the other hand, there is conflicting data regarding this treatment's efficacy for creeping obesity. According to studies on creeping fat by the Crohn's and Colitis Foundation, there was no difference in fat levels before or after anti-TNF therapy. Nonetheless, a different study published in 2021 claims that anti-TNF medications help prevent creeping obesity. According to the study, the therapy enhanced the tissue's physical characteristics while lowering intestinal inflammation. Decreased inflammation may lessen Crohn's disease symptoms. As a result, anti-TNF medications might be advantageous for treating Crohn's disease and creeping obesity. Additionally, the Crohn's and Colitis Foundation stated that creeping fat was unaffected by stem cell transplantation therapy.

What Are the Complications of Creeping Fat in Crohns Disease?

When a person has Crohn's disease, there can be several consequences.

• It can result in various symptoms, such as cramps, diarrhea, bloating, abdominal discomfort, and blood in the stool, comparable to a flare-up of Crohn's disease.

• The rate of intestinal injury was higher in those with creeping fat than in those without it.

• The study's findings indicate that creeping fat accumulation is associated with a higher risk of future abdominal surgery.

What Is the Prognosis of Creeping Fat in Crohns Disease?

If a person has both creeping fat and Crohn's disease, they are more likely to experience certain issues. They have a greater chance of suffering an intestinal injury and may see an aggravation of Crohn's disease symptoms. They might also be more likely to require surgery in the future. Anti-TNF medications can lessen the inflammation that creeping fat produces.

Conclusion

The term "creeping fat" describes the intestines as encircled by a mesenteric fat layer covering the abdominal organs. This may have major consequences, but it is a defensive reaction to a bacterial imbalance brought on by Crohn's disease. Crohn's disease patients who have creeping fat may have worsening symptoms as well as consequences like strictures and scarring. Doctors use anti-tumor necrosis factor (TNF) therapy to treat inflammation. However, the effectiveness of this treatment for creeping fat needs to be well-established. In addition to being more prone to intestinal disease, a person with creeping fat may also need colon surgery down the road.