Crohn's disease anal pain and fissures

[Anna204]

My daughter has been suffering from Crohn's for about 4 years- she is now 19. Most of her symptoms are well controlled by 6-MP. However, she has intense pain with bowel movements from small fissures and rectal spasm.  The pain may last several hours. We have tried botox, which worked for a little while but had urgency associated with it. She is afraid of surgery as no-one has been able to give her any clear idea of the risks of incontinence after surgery. Are there any other treatments available for her?

[hawaiianlily]

Your description of your daughters pain is exactly what I am now experiencing.  I have crohns and I had surgery because I was having so much pain in my rectum which I'd been enduring for about a year and you are right--do not have surgery.  It made me so much worse than before. I have terrible pain after a BM including spams that can last for hours afterward and my rectum now leaks all day.  I went to see another surgeon and he said there was nothing that can be done but more surgery.  When I was first diagnosed with crohns about 5 years ago I got a fistula which is different from a fissure and it went undiagnosed for months until I wound up in the ER.  At that time I was lucky and had a great surgeon that cleaned out the infection, but at that time I had be suffering with hemmroids giving childbirth and I asked her if she would remove them while I was in surgery and she said never ever would she do any surgery other than what she did because crohns patients do not heal well.  Now moving to the present time and dealing with this new rectal pain I went to see a gastro dr. who tried to perform a colonoscopy but had to stop because the pain was so unbearable, anyway he sent me to a surgeon and I was told you need surgery to find out whats going on and apparently I had an internal hemmroid that was removed, and the recovery was horrible, It took 5 months before I began to heal and I am in worse condition now than before.  Now I've had two gastro docs tell me that if my pain is that bad I should just opt for a colostomy bag.  

The drug Remicaid is specifically used on patients who have fissures and I understand it works well even though the temporary side effects are not good, but worth a try and better than surgery.  I spoke with a women who gets fissures all the time and she said Remicaid was her life saver.  Can you tell me what 6-MP is, I have never heard of that medication and I am not on any medication for my crohns because the only drug the last four doctors have prescribed is Asacol and I get no relief from that medication at all.

I've tried every rectal supository and topical cream thats ever been created and they have never given me much relief.  A sits bath can help a lot!

[PrincessKatie]

Has she tried rectal supositories and topical creams? I have perianal Crohn's with a skin tag and I was told not to have surgery because it just makes it worse in the long run. (I'm 21.)