Ix. Ecologic Model

IX. Ecologic Model

Hypothesis The patient developed bleeding hemorrhoids resulting from straining during defecation. Due to insufficient intake of fluids and vegetables, it is hard for him to eliminate bowel.

Predisposing Factors 1.Host - any organism that harbors and provides nourishment for another organism. 38 years of age Male Islam Filipino Living together with his 2nd family. Bathing 3x a day. Avoid smoking cigarettes and occasionally drink alcohol beverages. Does not drink coffee, just milk. Does not eat spicy foods nor junk foods. Not using drugs or over-the-counter drugs as a way of handling stressful situations or problems.  Does not eat variety of foods each day, inadequate intake of fluid.  Does not have time participating in individual, family activities that increases level of fitness          

such as exercise. Walking a little is enough.  Too much rubbing of the anal are can cause irritation.     

During childhood, used to eat guava and started to experience constipation. Passes stool in 2-3 days Once constipated, he usually drink water and apply some ointment. Does not eat pork’s meat as prohibited by religion. No hereditary diseases, he’s the only one who has hemorrhoid in the family.

2. Agent

-an environmental factor or stressor that must be present or absent for an illness to occur.

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Prior disease: infectious diarrhea, sore eyes, chickenpox, bulutong , pegue Deficiency in nutrients and fiber intake Lifting heavy objects during work Prolong sitting Long period of standing Allergy to certain drug Lack of sleep

3. Environment -includes all factors external to the host that makes illness more or less likely.

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Neighbor smokes House near wet market may indicate water pollution Source of drinking water from faucet may be contaminated. Patient is away from his 1st family. (married twice) Do not have own toilet, tendency to share with neighborhood.

Ecologic Model

Analysis We have observed that there are many factors contributed to the development of hemorrhoids to our patient, namely individual vulnerability(host),intrinsic properties(agent), and environmental factors. This model describes the contributing factors that cause hemorrhoids to our patient. Identification of risks factors resulting from interaction of agent-host-environment are helpful in maintaining and promoting health.(Fundamental of Nursing by Kozier)

Hemorrhoid is common to young adults because of some changes in their lifestyle. Age also plays an important role, because as we get older functions in the body also starts to be weak. Sedentary lifestyle may occur due to some stressors, not eating sufficient food and water leads to constipation. Our patient started to be constipated since he was a child, and not paying attention to it until it reached 3 rd degree hemorrhoid. Because of insufficient intake of fluid and vegetables his situation worsen and making it more hard for him to defecate. During his work, he

used to lift heavy objects which can put pressure to the anal canal thus exacerbate the existing hemorrhoid. They don’t have their own toilet so its hard for them to defecate. Sometimes when "nature calls" there is no toilet available. Usually, by postponing bowel movement, the urge to defecate goes away and does not return until after eating another meal. While occasionally postponing bowel movement does no harm, doing it regularly can contribute to hemorrhoids.

Conclusions and Recommendations The researchers therefore conclude that hemorrhoids are swollen, inflamed veins or vascular cushions in and around the anus and lower portion of the rectum. When the cushions become enlarged, inflamed, thrombosed or prolapsed, they produce symptoms and are then referred to as hemorrhoids. General treatment measures include a high-fiber diet and adequate fluid intake to avoid constipation. Stool modifiers such as softeners or bulk formers may also be given, and cultivating regular bowel habits may help prevent chronic hemorrhoids. Irritation of the skin around the anus may be relieved by ointments or suppositories. Analgesics and sedatives may be helpful. Warm sitz baths relieve pain and swelling, and help prevent infection. Suppositories or astringent compresses also may be used to relieve symptoms. Antibiotics are sometimes indicated. The acute pain subsides over a period of 1 to 2 weeks, with the thromboses gradually being reabsorbed over a 1 to 2 month period. After the acute attack, the hemorrhoids may be ligated or removed surgically (hemorrhoidectomy). Surgery is usually reserved for either reducible or non-reducible hemorrhoids that have severe symptoms or complications (third- and fourth-degree hemorrhoids).