Oh Decrapster, you souind so much like me. And I'll tell you, my GI told me he uses me as his "worst case scenario" when talking about fissures to other patients! I used to drive to work standing up. Lost 30 pounds trying not to poop!
Anyway, Remicade is very, very good at taking care of rectal issues. If I could go back to May 2005 when I was first diagnosed, I'd start on the R right away. It has risks, but so does everything and you know you can't live like you're feeling now. Really, I spent many, many dollars and tried many different things.
Surgery is also a choice, but could be dangerous. I kind of decided that surgery would just "hide" the symptoms for awhile but Remicade would truly make them go away.
Bad fissure Feb 2005, still have it January 2006. On Pentasa and Imuran 100mg. Some slight swelling and ulceration of terminal ileum. No other symptoms. Now on Remicade!