Gut Bacteria and Creeping Fat in Autoimmunity

Initially the title sounds like a title for a bad horror film written by a biologist.  Creeping fat brings up images of the old “Blob” movies.  The reality is that scientists found a link between a gut bacteria moving through the intestinal walls of patients with autoimmune Crohn’s disease and a complication of fat accumulation around the intestines.  Understanding a mechanism can lead to a therapy.  Beyond that, we again see the interplay between our gut bacteria and our immune system exhibited in an autoimmune condition.

Crohn’s disease is a common autoimmune condition in which our immune systems attacks the cells lining your intestines.  This leads to inflammation, ulceration, bleeding, malabsorption of nutrients, pain, infection, and sometimes surgeries.  A portion of the Crohn’s sufferers develop fibrosis which can scar off and block the intestinal flow.  During surgery, creeping fat, or excess accumulation of fat, is found around the sections of intestines with active inflammation.  Scientists have not been sure whether this was contributing to worse disease or the body’s attempt to control the disease.

The researchers examined the removed creeping fat from 11 Crohn’s patients who required surgery.  Their experiment indicated that the fat was responding to a particular bacteria called Clostridium innocuum that had migrated out of the intestinal lumen and into the intestinal wall.  Normally, this and other bacteria remain inside the intestinal lumen contributing to the gut microbiome.  In Crohns disease this bacteria may be contributing to the creeping fat and maybe the scarring.

This clostridium is one of many clostridium that may live in our guts.  Many know of the more dangerous Clostridium difficile which causes post-antibiotic colitis.  In some patients after a course of antibiotics, this C. diff bacteria overgrows and leads to fever, abdomen pain, bloody diarrhea, and in the elderly sometimes leads to death.  There are other clostridial bacteria which live in everyone’s GI tract which stir up little to no trouble and there are some clostridia which if they grow too large in number can worsen autism symptoms in children.  To find one more clostridia which contributes to another human disease should not be surprising.

In functional medicine, we may drive some patients crazy by refusing to ignore gut health.  They wonder why we focus so much on digestion and gut bacteria.  Research like this encourages us to continue to educate our patients and modulate their GI function.  Helping them live healthier more abundant lives requires our perseverance.

Thanks to Science Daily

Cedars-Sinai Medical Center. “Medical mystery: ‘Creeping fat’ in Crohn’s patients linked to bacteria.” ScienceDaily. ScienceDaily, 1 October 2020. <www.sciencedaily.com/releases/2020/10/201001090138.htm>. Accessed October 3, 2020.