: Progressive, chronic malabsorptive state occuring in certain tropical countries due to probaly small bowel bowel bacterial over growth leading to partial, villous atrophy. Occurs in indigenous populations as well as foreigners having an extended stay in these countries.

• Subclinical malabsorption, common in many developing countries causes similar mucosal changes but without any symptoms.
• A starting as an acute diarrhoeal problem but gets persistent over several months leading to weight loss and manifestation of deficiency of folate, Vitamin B 12 besides other nutrients.
• biopsy after excluding parasitic infections.
• Diagnosis by confirming folate and B12 deficiency with megaloblastic anaemia, and by intestinal