DIVERTICULOSIS OF THE SMALL INTESTINE AND MEGALOBLASTIC ANEMIA

. Megaloblastic anemia and small intestinal diverticulosis in a 79-year-old woman are reported. Laboratory studies showed normal secretion of intrinsic factor and that the anemia was due to defective absorption of vitamin B12. The bacterial concentration in duodenal fluid was 3,400,000 E. coli per ml. In vitro the bacteria had a high uptake of “free” 57CoB12 and a low uptake of 57Co bound to intrinsic factor. This supports the theory that small intestine bacteria cause vitamin B12 malabsorption by inhibitory action on the absorptive epithelium.