I'ld try the lortramin and some probiotics (yogurt). You should see improvement within 24 hours and you can get lortramin over the counter. If it isn't improving than take him in. Sorry you guys are going through this. I hope he feels better soon.
I found this recipe. They said the antacid soothes the pain.
Magic butt cream is equal parts
-Desitin (the thick original- not the creamy)
-Maylox (or store brand, mint flavor is more 'cooling' on baby's bottom)
-Lotramin AF (you have to make sure it is the anti fungal)
it may be kind of lumpy at first and may separate in between uses- but this stuff is the BEST. If your friend has good Rx coverage, her doc can call it in and the the pharmacy can make it for her- they use all the same ingred, except they use nystantin instead of the lotramin