American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the maximum duration of acute diarrhea without alarm features that should be evaluated?

1. 3 days

2. 1 week

3. 10 days

4. 2 weeks

The correct answer is: 1 week

Acute diarrhea is typically defined as diarrhea that lasts less than two weeks. While many episodes resolve within a few days, evaluating a patient after one week of persistent symptoms without alarm features is essential for determining the need for further investigation. This timeframe allows healthcare providers to assess potential underlying causes that may not be immediately apparent, such as infections, inflammatory bowel disease, or functional gastrointestinal disorders. The rationale for assessing patients after one week is also founded on the understanding that diarrhea persisting beyond this duration may indicate a higher likelihood of complications or more serious underlying conditions, even in the absence of alarm features like blood in the stool, severe abdominal pain, or fever. By evaluating a patient at the one-week mark, clinicians can initiate appropriate diagnostic testing or management strategies. Diarrhea lasting longer than this, up to two weeks, or more, usually prompts further evaluation, but the critical threshold for initial assessment is set at one week to ensure timely intervention and to monitor for any changes in the patient’s condition.