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Paper short abstract:

Creeping fat is a mysterious part of Crohn’s disease (CD), protecting the gut from bacterial leaks at the cost of obstruction. Leaks and obstructions make some with CD feel the gut is haunted by ghosts. This paper explores subjectivity via uncanny gut processes that make a g(host)ly body habitable.

Paper long abstract:

Crohn’s disease (CD) is an inflammatory bowel disease (IBD) that affects all layers of the gastrointestinal tract. Chronic inflammation erodes the bowel, risking perforation. As the inside/outside threshold of the gut collapses, fecal bacteria gravely flood the body. Severe CD is characterized by a mysterious phenomenon called “creeping fat.” Finger-like projections from adjacent abdominal tissue wrap around gut lesions, causing obstructions as the gut narrows. Creeping fat remains enigmatic because it cannot be clearly distinguished through medical imaging nor directly experienced. Recently, a microbial theory has posited creeping fat as a harmful and protective consequence of gut perforation. It prevents fecal flooding of the host environment at the expense of bowel obstruction. Amidst the microbial creep of leaks and obstructions, some with IBD feel their gut is haunted by ghosts. In the same breath, gut ripples are recognized as bacterial blooms and phantoms of surgical resection. Based on ethnographic fieldwork in New York City, this paper explores the convergence of the microbial host and the ghosts of haunted guts through the metabolic processes and experiences of people living with CD. How does subjective life persist through the uncanny gut when the mediating capacity of this inside/outside border is overspilled by its own microbial entanglements? Approaching the uncanny metabolically, reveals a form of subjective existence that continues at the limits of microbial embrace. In the wake of perforation, creeping fat becomes how people living with severe CD come to inhabit a g(host)ly body in the gaps of a narrowing gut.