8 yo female with illeocolonic Crohn's disease.
Bowel disease in remission on Asacol.
Never had fistula in ano, etc, but Waxy hemorrhoids for years.
Now has increase in size of these there are at least 10, some as large as 3-5cm. There's mild anal stenosis on digital, but no functional impairment.
Needless to say, they are painful, difficult to keep clean and interfere with intercourse (vaginal, they cause pain, not obstruction -- this is America -- 18 is old to first be sexually active).
What approach would you take?