Amathumbu amancane (avela esiswini sesiLatini, aphuma emathunjini, okusho ukuthi “ngaphakathi”) isitho somgudu wokugaya ukudla.

I-Localisatiohhayi. Amamitha ayi-5 kuye kwayi-7 ubude no-3 cm ububanzi, ithumbu elincane lilandela isisu futhi landiswa amathumbu amakhulu (1).

Ukwakheka. Amathumbu amancane akhiwa izingxenye ezintathu (1) (2):

• I-duodenum itholakala phakathi kwe-pylorus yesisu ne-duodeno-jejunal angle. Imiswe njengo-C futhi itholakala ngokujulile, yakha ingxenye engaguquki yamathumbu amancane. Amapayipi angaphandle avela kumanyikwe kanye nomgudu wenyongo afika kulesi sigaba.
• I-jejunum iqala ekhoneni le-duodeno-jejunal futhi ifinyelela ku-ileum. Yakha, nge-ileum, ingxenye enkulu yamathumbu amancane.
• I-ileum ilandela i-jejunum futhi ifinyelela ku-valve ye-ileocecal, eholele emathunjini amakhulu. I-ileum ne-jejunum bakha ingxenye ehambayo yamathumbu amancane.

Wall. Amathumbu amancane akhiwe ngezimvilophu ezi-4 (1):

• Ulwelwesi lwamafinyila ungqimba lwangaphakathi oluqukethe izindlala eziningi, lukhipha ikakhulukazi isikhwehlela esivikelayo.
• I-submucosa ungqimba oluphakathi olwakhiwe ikakhulukazi lwemikhumbi nezinzwa.
• I-muscularis ungqimba lwangaphandle olwakhiwe ngemicu yemisipha.
• Ulwelwesi lwe-serous, noma i-peritoneum, imvilophu ehlanganisa udonga olungaphandle lwamathumbu amancane.

Ukugaya. Ukugaya kwenzeka ikakhulukazi emathunjini amancane, futhi ikakhulukazi ku-duodenum ngokusebenzisa ama-enzyme wokugaya kanye ne-bile acid. Ama-enzyme okugaya avela kuma-pancreas ngokusebenzisa amapayipi angaphandle, kuyilapho i-bile acid ivela esibindini ngemigudu ye-bile (3). Ama-enzyme wokugaya ukudla kanye ne-bile acid kuzoguqula i-chyme, uketshezi oluqukethe ukudla okusungulwe amajusi wokugaya esiswini, kuya ku-chyle, uketshezi olucacile oluqukethe imicu yokudla, ama-carbohydrate ayinkimbinkimbi, ama-molecule alula, kanye nezakhamzimba (4).

Ukwamukela. Ngomsebenzi wawo, umzimba uzomunca izakhi ezithile ezinjengama-carbohydrate, amafutha, amaprotheni, ama-electrolyte, amavithamini, kanye namanzi (5). Ukumuncwa kwemikhiqizo yokugaya kwenzeka ikakhulukazi emathunjini amancane, futhi ikakhulukazi ku-duodenum nejejunum.

Ukuvikelwa kwamathumbu amancane. Amathumbu amancane azivikela ekuhlaselweni ngamakhemikhali nangomshini ngokufihla amafinyila, evikela ulwelwesi lwamafinyila (3). Amathumbu amancane nawo avikelekile ekungcolisweni amagciwane asemathunjini amakhulu ngenxa ye-valve ye-ileocecal.

Isifo samathumbu esingapheli. Lezi zifo zihambisana nokuvuvukala kolwelwesi lwengxenye yohlelo lokugaya ukudla, njengesifo sikaCrohn. Izimpawu zifaka phakathi ubuhlungu obukhulu besisu kanye nohudo (6).

Isifo samathumbu esicasulayo. Lesi sifo sibonakaliswa yi-hypersensitivity odongeni lwamathumbu nokungahambi kahle kwezingcindezi zemisipha. Izibonakalisa ngezimpawu ezahlukahlukene ezifana nohudo, ukuqunjelwa, noma ubuhlungu besisu. Isizathu salesi sifo asikaziwa nanamuhla.

Ukuvinjwa kwamathumbu. Kukhombisa ukumiswa kokusebenza kokuhamba, kubangele ubuhlungu obukhulu nokuhlanza. Ukuvinjelwa emathunjini kungaba yimvelaphi yemishini ngokuba khona kwesithiyo ngesikhathi sokuhamba (amatshe enyongo, izicubu, njll.) Kepha futhi kungaba ngamakhemikhali ngokuxhunyaniswa nokutheleleka kwezicubu eziseduze, ngokwesibonelo ngesikhathi se-peritonitis.

Isilonda se-Peptic. Lesi sifo sihambisana nokwakheka kwesilonda esijulile odongeni lwesisu noma leso se-duodenum. Isifo se-Peptic ulcer sivame ukubangelwa ukukhula kwamagciwane kepha singenzeka futhi lapho uthatha imishanguzo ethile (7). 

Ukwelashwa. Ngokuya nge-pathology etholakele, izidakamizwa ezithile zingabekwa njengezidakamizwa ezilwa nokuvuvukala noma ama-analgesics.

Ukwelapha okuhlinzwa. Ngokuya nge-pathology kanye nokuziphendukela kwayo, ukungenelela kokuhlinzwa kungenziwa.

Ukuhlolwa komzimba. Ukuqala kobuhlungu kuqala ngokuhlolwa komzimba ukuhlola izimpawu nokuthola izimbangela zobuhlungu.

Ukuhlolwa kwezinto eziphilayo. Ukuhlolwa kwegazi kanye nesitulo kungenziwa ukwenza noma ukuqinisekisa ukuxilongwa.

Ukuhlolwa kwe-imaging yezokwelapha. Ngokuya nge-pathology esolwayo noma efakazelwe, kungenziwa izivivinyo ezengeziwe njenge-ultrasound, i-CT scan noma i-MRI.

Ukuhlolwa kwe-Endoscopic. I-endoscopy ingenziwa ukutadisha izindonga zamathumbu amancane.

Ngo-2010, abacwaningi bakwa-Inserm eNantes bashicilela imiphumela yabo yocwaningo ngemiphumela yesifo sikaParkinson kuma-neurons wokugaya ukudla kumagazini wesayensi iPlos One. Bakhombisile ukuthi izilonda zesifo sikaParkinson azithinti kuphela amangqamuzana wohlelo lwemizwa oluphakathi, kepha futhi nalawo wohlelo lwezinzwa olungena ngaphakathi, futhi ngokunembile kakhulu kohlelo lokugaya ukudla. Lokhu kutholakala kungavumela ukutholakala kwesifo sikaParkinson kusenesikhathi (8).