Namaste Lok Bahadur Ji, Antibiotics are generally not used for internal hemorrhoids (piles) unless there is an associated infection. Since you've already followed a fiber-rich diet, Sitz baths, and topical treatments without significant improvement, I recommend consulting your surgeon for a re-evaluation. Also for second-degree hemorrhoids, minimally invasive procedures like rubber band ligation and electrocoagulation can effectively reduce symptoms without requiring surgery. Wishing you a speedy recovery! Let me know if you need more information.