Should I consider surgery or a new med

These are questions best directed at your gastroenterologist (not a surgeon). Your decision will have to be based on how long you have had the disease, the severity and your quality of life. Having said that, The immuno-modulating therapies like Humira remicade etc have proven particularly effective at closing fistulas and healing ulcerations. I would think that your GI will strongly recommend a test of stronger medications before opting for the surgical route. It may seem like the promise of a fresh start, but surgery carries its own set of problems. If I had active fistulzing crohn's, I would not want anyone opening up my gut, unless it was absolutely necessary. I suspect the rate of complications is much higher, including the risk of post-surgical abscess and new fistulization. If you have multiple fistulas communicating between bowel loops, you will likely have to lose a lot of bowel to surgery.

Be prepared to have a frank discussion with your GI. Share your concerns. Get all the pros and cons of all your options out on the table. Only then will you be able to make the decision that is right for you.