My mother recently tested positive for H. pylori and is seeking treatment. She suggested that my twin brother and I also get a blood test to see if we have the infection as well. Is this really necessary? Does H. pylori infection have anything to do with heredity?

Q.

Helicobacter pylori (H. pylori) is a bacterium commonly found in the stomach. In most people, this germ, which is spread through oral contact, does not cause any disease or symptoms. However, in a minority of patients, H. pylori infection can cause ulcers in the stomach and/or upper intestine (duodenum). We do not yet know exactly how H. pylori leads to ulcer formation or why only a small proportion of infected patients develop ulcers.

H. pylori is also associated with stomach cancer, a very rare disease in the United States. It is thought that the chronic inflammation caused by the bacterial infection may somehow spur the development of cancer many years later. Again, we do not know why only a small percentage of patients infected with the bacterium develop this complication.

There is no known inherited predisposition to H. pylori infection. Thus, the fact that your mother tested positive for H. pylori should not be a cause for alarm for either you or your brother. In fact, many older people in the United States are infected with H. pylori, but suffer no symptoms. Your risk of infection is roughly equal to your age -- for example, a 40-year-old has about a 40 percent chance of having H. pylori.

Current recommendations for treating H. pylori are somewhat controversial. All patients with ulcer disease should be tested and, if positive, treated with bacteria-killing antibiotic drugs. In addition, patients with stomach cancer should also be tested and treated. Also, some doctors will test and treat patients who do not have ulcers, but who suffer from upper abdominal pain, burning and/or nausea. At this time, it is not recommended that people with no gastrointestinal symptoms be tested or treated for H. pylori.