OpenHealth Q&A

Could it be Crohn's Disease?

Patient Details: - Age: 39 - Gender: Female - Height: 5 feet 8 inches - Weight: 219 pounds Summary: Is creeping fat associated with any conditions other than Crohn's disease? On July 25, I visited the emergency room due to alarming symptoms. I was unable to retain any food or fluids; even water would lead to vomiting within 15 minutes. Additionally, I experienced diarrhea that contained a considerable amount of blood. A CT scan revealed inflammation in my colon, leading the attending physician to diagnose me with colitis and prescribe anti-nausea medication, although she did not provide antibiotics, suspecting a viral infection. The following week was extremely challenging. I struggled to keep any food down and faced constant dizziness and nausea, compounded by severe constipation—seven days without a bowel movement. A week later, on August 1, my condition worsened considerably, prompting another trip to the emergency room where I was admitted. The diagnosis at that time was infectious colitis, possibly C. difficile colitis. Although I presented with bloody diarrhea at the ER on August 1, I was unable to submit a stool sample during my hospital stay. I remained hospitalized until August 4, during which I received IV antibiotics (Cipro and metronidazole), fluids, and was put on a soft food diet. Upon discharge, I was given a prescription for Cipro and metronidazole, along with instructions to schedule a follow-up with a gastroenterologist for a colonoscopy. During my GI follow-up on August 8, I was seen by a nurse practitioner rather than my original doctor. By then, my symptoms had shown some improvement, although I was still restricted to bland soft foods and could only manage half a cup of soup or a cup of pudding daily. The nurse practitioner suggested that my condition might not be infectious colitis but rather ulcerative colitis. She prescribed Xifaxan and arranged for a colonoscopy on August 22. However, I still had not experienced a bowel movement by this point. On August 18, my symptoms intensified. Although I felt the urge to have a bowel movement, the attempt caused extreme pain, accompanied by sweating and dry heaving. I contacted my physician on August 19, who prescribed another course of Cipro and assured me that the colonoscopy preparation scheduled for August 21 would facilitate a bowel movement. I was increasingly anxious about attempting to go to the bathroom due to the pain. The situation escalated, and I found myself back in the emergency room at 1:00 a.m. on August 20. Another CT scan revealed inflammation not only in my colon but also in my small intestine and appendix. I was admitted once again, and my diagnosis shifted to colitis, gastroenteritis, and appendicitis. My condition failed to improve despite being treated with IV antibiotics, fluids, Zofran, and pain management. I was maintained on an NPO or clear liquid diet throughout this period. Finally, I managed to have a bowel movement on Thursday, albeit painfully, but felt a sense of relief afterwards. I provided a stool sample then as well. On Sunday, I suffered another severe flare-up of symptoms, leading to yet another CT scan. This scan indicated that while my colon was no longer inflamed, there was increased inflammation in my small intestine, and my appendix remained swollen but unchanged from Wednesday's scan. Finally, I had an opportunity to speak with my GI doctor in the hospital, but he was not aware of that morning's CT results. He promised to review them and get back to me, yet I heard nothing afterward. I consulted with a surgeon who determined that I would undergo an appendectomy on Monday. She expressed her suspicion that my symptoms could potentially be linked to Crohn's disease rather than appendicitis, but due to existing swelling, she advised the removal of my appendix to prevent further complications. She also mentioned that the surgery would allow for a closer examination of my gastrointestinal tract, especially since my scheduled colonoscopy on the 22nd was not possible. After the appendectomy, I found myself in recovery, where the surgeon shared photos from the operation. The images revealed noticeable swelling and discoloration in my small intestine, as well as an occurrence termed "creeping fat," which she indicated could signify Crohn's disease. My appendix was sent for biopsy, and the photos were forwarded to my GI doctor with the expectation that he would contact me later that day. Unfortunately, I did not hear from him that day. At 3:00 a.m. now, I lie in my hospital bed, struggling to find rest amid pain from the appendectomy, nausea, and anxiety about my condition. My online research suggests that "creeping fat" seems to be attributed solely to Crohn's disease. While I understand that a diagnosis cannot come from a forum, I wonder whether creeping fat can be seen in any other conditions and what my chances are of being diagnosed with Crohn's disease.

Answers (1)

8/26/2025, 8:21:42 AM

OpenHealth AI

I'm sorry to hear about the intense difficulties you’ve been experiencing. Your symptoms and the findings from your recent surgeries are understandably concerning, and it's completely normal to feel anxious about your health.

Main Points: Creeping fat is often associated with Crohn's disease, but it may also be observed in other gastrointestinal conditions, such as chronic pancreatitis or intestinal malignancies. While a definitive diagnosis requires further evaluation, your symptoms warrant close monitoring and follow-up care.

Explanation:

"Creeping fat" refers to a phenomenon in which fat expands along the surfaces of the intestines, often seen in chronic inflammatory conditions like Crohn’s disease. However, it is not exclusive to Crohn's disease and can appear in various conditions that cause prolonged inflammation. Given your recent hospitalization, appendectomy, and the specifics of your symptoms, it’s crucial to follow up with your healthcare providers for further testing.

Next Steps:

1. Follow-Up Appointment: Ensure that you follow up with your GI doctor as soon as possible, especially given the biopsy results from your appendix and any relevant imaging findings. This will provide you with clarity on your diagnosis.

2. Symptom Monitoring:

   • Keep a detailed log of your symptoms, including pain levels, bowel movements, and any food intake reactions. This information will be helpful in future consultations.
   • Note any new symptoms that arise, such as worsening pain or changes in your bowel habits.

3. Manage Pain and Nausea:

   • Discuss pain management with your doctor, especially after surgery, to ensure that your recovery is as comfortable as possible.
   • Stay hydrated and consider simple broth or electrolyte solutions to keep your fluid levels balanced.

4. Nutrition:

   • As your condition stabilizes, consider gradually reintroducing bland foods, but proceed cautiously. Work with a dietitian if possible to help identify safe foods that are easy on your digestive system.

5. Reduce Anxiety:

   • Engage in relaxation techniques, such as deep breathing exercises or guided imagery, to help manage anxiety regarding your health. It might be helpful to talk to a counselor or support group if you're feeling overwhelmed.

While it is understandably a tense time for you, staying proactive in your care and maintaining open communication with your healthcare team will empower you as you navigate your health challenges. Feel free to reach out if you have further questions or need more support.