### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I recently had a ct scan . I have msk and am a stoneformer. The scan showed a 5mm in midpole of my right kidney and a 2mm in upperpole of right kidney also multiple stones in both but more prominent in right that couldn t be measured accurately. Multiple stones isn t unusual in my case. I am having nausea and the pain in my side and right side of my back(flank) also blood in my urine . Should these stones be causing this pain? I have had more than several stones. Also I heard of a procedure where all stones could be removed. Is this something I should consider and speak to my urologist about considering my situation?

### output:

Hi, Many thanks for the query! You need to do certain basic investigations first, which include-USG (PUB), Urine routine & microscopy, Sr. creatinine, Sr. uric acid. Blood in urine is usually due to Ca-oxalate stones having spikes on their surface causing mechanical trauma to mucosa of urinary tract & bleeding. Pain is due to spasms of the ureter to get rid of the stone by more frequent & powerful contractions to propel it out.Also, as you have recurrent stones, do- Metabolic workup of 24 hrs urine sample, Sr. PTH, Sr. Calcium. As per the reports, appropriate diet instructions can be given & if Sr. uric acid is raised, Uric acid synthesis inhibitors like allopurinol can be started. Along with thiamine diuretics, you need to take Potassium Magnesium citrate, also take urine alkalizing agents with your Urologists opinion. Take symptomatic treatment as per Urologists opinion till you get your investigations done, viz. Plenty of oral fluids, antispasmodics, urinary alkalinizing agents, painkillers.5 mm & 2 mm stones need not be removed surgically, they will come out with above medicines. Wish you a good health. Take care. Regards.