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Diverticular disease, including diverticulitis, is common in geriatric patients and may be chronic, resulting in recurrent episodes of abdominal pain, bloating, cramping, and constipation or diarrhea. These symptoms may cause substantial emotional distress, anxiety, and depression, leading to poor quality of life. Diverticular disease is also associated with several complications, including abscess and perforation, which can increase the risk of morbidity and mortality. Heightened understanding of diverticular disease is resulting in changes to guidelines for diagnosing, treating, and preventing recurrences. In this article, the authors discuss the latest findings and recommendations regarding diverticulitis, which are transitioning care away from more invasive strategies to more conservative ones

A 60-year-old man with a history of hepatic cirrhosis and cardiomyopathy underwent transoesophageal echocardiogram. He received mild sedation and topical lidocaine. During the recovery period the patient developed ataxia and diplopia for about 30 mins, a result of lidocaine toxicity. The patient was administered a commonly used local anaesthetic, a combination of 2% viscous lidocaine, 4% lidocaine gargle and 5% lidocaine ointment topically to the oropharnyx. The total dose was at least 280 mg. Oral lidocaine undergoes extensive first pass metabolism and its clearance is quite dependent on rates of liver blood flow as well as other factors. The patient's central nervous system symptoms were mild and transient but remind us that to avoid adverse side effects, orally administered drugs with fairly high hepatic extraction ratio given to patients with chronic liver disease need to be given in reduced dosages. Even 'Safe' medications need to be carefully administered.