I have crohn’s colitis and skin tags. I have had many many (almost every) non-GI doc think they were hemmies- they are not. Here’s what I can give you based on my experience/knowledge:
1. I would say it’s likely they are tags because they are just so common with perianal crohn’s. They can get bigger or smaller due to the level of disease- but mine have only ever gotten bigger or stayed the same.
2. My don’t hurt unless I have a fissure on them or I have a rash from the moisture. They are just there and mine are very extensive, they surround my entire anus and look like little mountains. Still, they don’t generally hurt. They are flesh colored and are a pain to keep clean. Sometimes, they will throb after I use the bathroom, especially in a flare. They can also be very itchy (if this is very bothersome, prep-h works wonders).
3. Not at all- I now have three fistulas with setons, but that just happened this year, I went many years without anything worse than a fissure. Unfortunately, in my case at least, the development of the fistulas/abscesses coincided with a significant progression of the severity of my disease. I went from Asacol tablets to biologics pretty quickly.
4. A flare is different for everyone- I’ve been flaring constantly for the past 3 or so years. My disease just keeps getting worse. I measure by how much medication I need- about 4 years ago, even though I had already been diagnosed, I didn’t take any meds. I would just have some paid and D if I ate really badly but otherwise that was it. Now, the Cimzia is helping but I still have some issues. I guess that’s not a very good answer, but it’s my experience.
5. If they are tags, they should shrink down (maybe not completely) when the inflammation lessens. If they are hemmies, they could probably shrink too, but hemmies are treatable, tags are not. Every Dr I’ve ever asked said it’s a bad idea to try and remove the tags because they comprise of sphincter muscle.
6. I’m guessing they could the same as anyone.
I say that all of the above are a pain in the butt haha! I have a crohn's ulcer the size of a 50 cent piece in the rectum area. This is very painful and hard to heal. Remicade is the only med that helped me with that. I also have an abscess that forms a rectal/vaginal fistula pops, drains, the humira heals the fistula and the abscess pools again. Lots of fun! Ask as many questions as you need to, because there always seems to be a piece of the puzzle missing. You certainly aren't alone in this venture.
All the best,