maximum size dilator

I wouldn't change this without consulting your doctor. If you've actually dilated your stricture to 18 mm without results then that stricture isn't likely to be your problem. You may need some adjustment to your dilator technique, or evaluation of a second problem.

Can you advise me on technique because my surgeon just told me to lube up and slowly built up to 18 by just inserting it gently through the stricture at the connection site?

I think the only "technique" issue would be if you are actually inserting it to 18mm at the stricture. The other thing might be frequency. If you are dilating daily I think that is the best it will be.

What we don't know is if your stool is too thick, if you have pelvic floor dysfunction, or pouch prolapse/twisting. Anal dolation would not affect these things, just anal stricture.

Jan

I'm definitely getting it past the stricture daily but it does seem I need to have a precise consistency that is impossible to duplicate every day. Too thin and not enough bulk to empty and too thick and I never ever feel empty. I have been dxd with pelvic floor issues but multiple biofeedback physical therapy sessions have not been successful. I even went to the top therapists at Cleveland clinic Ohio. Any other options?

You can do tap water enema rinses to help evacuate. Not ideal, but should do the job. 

I do better with looser output, so I don't limit fruits and vegetables.

Jan

I think I'll start some fruits. Thank you Jan....