High direct bilirubin means that the test value is higher than normal, which may be caused by physiological reasons such as strenuous exercise, or pathological reasons such as hepatitis, cirrhosis, biliary obstruction, congenital hyperbilirubinemia, and so on. 1. Physiological reasons: high direct bilirubin may be caused by physiological factors such as staying up late at night, strenuous exercise, etc., which is usually only transiently elevated and can be relieved after rest. 2. Pathologic causes: high direct bilirubin may also be caused by liver and gallbladder diseases. Hepatitis, cirrhosis and other patients, due to inflammation or damage of liver cells, bilirubin can not be converted into bile normally, which will cause high direct bilirubin. Capillary obstruction in capillary type hepatitis, direct bilirubin can not be normally discharged from the biliary tract, so the direct bilirubin in the serum is elevated. Hepatobiliary and pancreatic diseases causing intra- and extra-hepatic biliary obstruction, and congenital hyperbilirubinemia can also have high direct bilirubin. For patients with liver disease, a slight elevation of direct bilirubin has relatively little effect, while a significant increase suggests a serious condition, which must be actively cooperated with the treatment to prevent further development of the disease.