If you are diagnosed with diverticulosis and told to avoid seeds and nuts, does that include tomato seeds and seeds in fresh berries or canned sauces? How about candy sprinkles, chocolate chips and other small food items?

L.Z.

Diverticulosis is an acquired condition in which the colon wall develops multiple, small outpouchings. The risk of diverticulosis increases with age, and it is estimated that it afflicts more than half of people over age of 60. Doctors do not know the exact cause, but among the factors being considered are lack of dietary fiber, the aging process and chronic constipation.

The most common complication of diverticulosis is infection, often referred to as diverticulitis. Diverticulitis is thought to occur when a small amount of fecal matter becomes stuck in an outpouching (diverticulum), leading to an infection that erodes through the colon wall and causes inflammation. The symptoms of diverticulitis typically are severe, left-sided abdominal pain, fever, and diarrhea or constipation. Antibiotics are used to treat diverticulitis. However, in some cases the infection may spread beyond the small perforation and lead to an abdominal abscess that may require surgical drainage.

To reduce the likelihood of diverticulitis, doctors have historically recommended that people with diverticulosis avoid eating certain nuts and seeds -- both of which are not digested in the upper intestinal tract. The reasoning behind this recommendation was that seeds and nuts could theoretically plug up a diverticulum and lead to diverticulitis. Despite this reasonable hypothesis, there is no known case of such a blockage actually occurring and no proven benefit to avoiding seeds and nuts. Certainly, candy sprinkles and chocolate chips, both of which are composed of carbohydrates that are completely broken down in the small intestine, would never end up in the stool -- and, thus, pose no threat of blocking a diverticulum.

A smarter dietary recommendation for people with diverticulosis is to eat foods that are high in fiber -- and possibly even take fiber supplements -- to reduce the risk of diverticular formation and lessen the effects of constipation.