ten years in, I can only assume that your sis has been through the ringer as far as meds are concerned?
I wish there was a better pain pill to suggest, but she's kind of already at the top of the pain-killer food chain as far as I have experience. The only thing I can think would be to go through a rough week or two of lowering the dosage/and or switching meds to alleviate any "resistance" or immunity or whatever...
As far as healing the fistulas- I was lucky in that Remicade helped mine. It put me into remission almost immediately, and the fistulas only took a few weeks after that to disappear. If she can find ANYTHING to get her inflammation down it should, theoretically, help the fistulas to heal... It's hard to make suggestions because I don't want to just state the obvious, I mean - your sis has been going through this for 10 years so she probably knows quite a bit. Maybe if you could give us some more details of what she's already tried we can make some more specific suggestions... If Remicade didn't work, the next step is usually Humira or Cimzia or another biologic of some kind...
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
Remicade '05 through '08, with no other maintenance meds
Noticing a real difference with a Gluten-Free diet.
Cimzia (loading doses 2-12-09)
Probiotics, Digestive Enzymes, and Prednisone