Creeping fat is a type of fat that resides in the abdomen. It wraps around the walls of the colon. Creeping fat has close links to Crohn’s disease and can worsen its symptoms.
Mesenteric fat is fat that lies between the outer layer of the intestine and the abdominal muscles. It runs almost the entire length of the colon, which includes the small and large intestines.
This mesenteric fat can sometimes wrap around the colon. This is what doctors call creeping fat.
This article outlines what creeping fat is, how it affects people with Crohn’s disease, and possible treatments.
Creeping fat is a type of fat frequently present in people with IBD, predominantly in individuals with Crohn’s disease. However, it may be present in anyone with intestinal inflammation.
Fat builds up in many places around the body. Every person has mesenteric fat that lies in the abdomen between the outer layer of the intestines and the layer of muscle surrounding them.
The adipose in mesenteric fat
According to the Crohn’s and Colitis Foundation, creeping fat is the name for mesenteric fat that wraps around the wall of the colon. Intestinal inflammation can draw the mesenteric fat toward it, causing creeping fat.
Creeping fat can cover more than 50% of the colon. It can cause the colon wall to thicken and can have various effects on a person with Crohn’s disease.
Some research suggests that bacterial translocation may be responsible for the development of creeping fat.
Bacterial translocation is the
This is more common in people with Crohn’s disease. One systematic review states that there may be some evidence linking bacterial translocation with creeping fat development.
However, more research is necessary to determine the definitive cause of creeping fat in people with Crohn’s disease.
Healthcare professionals usually find creeping fat during imaging tests.
Creeping fat can have several effects on a person with Crohn’s disease.
Crohn’s is an autoimmune-mediated inflammatory condition. This means that atypical reactions in the immune system cause the symptoms of Crohn’s disease to arise.
The presence of creeping fat can increase the amount of intestinal inflammation. This can cause an increase in Crohn’s disease symptoms, such as:
- rectal bleeding
- the urgent need for a bowel movement
- abdominal cramps and pains
- the sensation of an incomplete bowel movement
Research has shown that creeping fat can also play a role in causing a number of changes to the connective tissues in the colon wall. These include:
- hypertrophy — increased muscular growth in the wall of the colon
- fibrosis — the excess accumulation of scar tissue in the colon wall
- stricture formation that causes the colon to narrow
These changes to the stricture of the colon wall can also affect a person’s Crohn’s disease symptoms.
Additionally, the buildup of scar tissue and structures in the colon can cause blockages. If a person has a blockage, they may experience some of the following symptoms:
- nausea and vomiting
- abdominal pain
- the inability to pass gas and stool
The main risk factor of creeping fat is an increase in visceral fat, which is the fat deeper in the stomach around organs. Visceral fat often has links to obesity, although some people with an average body mass index also have increased visceral fat.
IBD is also a risk factor for creeping fat.
Creeping fat can cause several complications for a person with Crohn’s disease.
It can cause a number of symptoms similar to a Crohn’s disease flare-up, including abdominal pain, blood in the stool, diarrhea, bloating, and cramping.
One 2019 study analyzed 90 people with Crohn’s disease. Using an MRI scanner, the study noted that over
The research authors stated that the presence of creeping fat increased the risk of complications associated with Crohn’s disease.
The study’s participants with creeping fat showed a higher rate of bowel damage than those without.
The study also concluded that there was a link between the presence of creeping fat and the need for abdominal surgery in the future.
There is a small amount of research into treating creeping fat.
According to the Crohn’s and Colitis Foundation, targeted therapies for creeping fat do not exist. They also state that creeping fat does not seem to change after treatment with anti-inflammatory therapy.
Anti-tumor necrosis factor (TNF) therapies are medications that doctors use
The Crohn’s and Colitis Foundation analyzed studies into creeping fat and stated that there was no change in fat before or after treatment with anti-TNF therapy.
However, another study from 2021 states that anti-TNF therapies have a positive impact on creeping fat. The study authors stated that the treatment improved the physical properties of the tissue reducing colon inflammation. Reduced inflammation can lead to a reduction in Crohn’s disease symptoms.
This would make anti-TNF therapies a beneficial treatment for people with creeping fat and Crohn’s disease.
The Crohn’s and Colitis Foundation also added that stem cell transplantation therapy did not affect creeping fat.
More evidence is necessary to look into possible treatments for creeping fat.
If a person has Crohn’s disease and creeping fat, they have a higher risk of certain complications.
They may experience a worsening of Crohn’s disease symptoms and have a higher risk of bowel damage. They may also have a higher likelihood of needing surgery in the future.
Some evidence suggests that anti-TNF therapies may help reduce the inflammation that creeping fat causes. However, more research is necessary to determine whether this is an effective treatment for creeping fat.
Mesenteric fat refers to fat that sits near the colon. Creeping fat refers to mesenteric fat that wraps around the colon wall. It is most commonly present in people with Crohn’s disease.
Creeping fat can lead to increased intestinal inflammation and the narrowing of the colon wall. This can worsen the symptoms of Crohn’s disease.
A person with creeping fat may also have an increased risk of bowel damage and may be more likely to require colon surgery in the future.
Anti-TNF therapies may be an effective treatment for reducing the inflammation relating to creeping fat. However, evidence regarding this is inconclusive, and more research is necessary to determine whether this is an effective treatment for creeping fat.