The causes of high total bile acids and normal liver function include physiological factors and pathological factors such as chronic hepatitis and gastrointestinal diseases, which require timely medical attention to identify the causes. 1. Physiological factors, the human body after eating a meal can appear high total bile acid, liver function is normal, after a certain period of time can generally return to normal, no need to deal with. Pregnant women may also have high total bile acids with normal liver function, which is an abnormality of bile acid metabolism caused by the change of hormone level during pregnancy. 2. Pathologic factors (1) Chronic hepatitis: Chronic hepatitis will lead to hepatocellular damage and obstruction of the enterohepatic circulation, which will lead to the elevation of total bile acids. The patient’s liver function may be normal. (2) Gastrointestinal diseases: common such as gastric ulcer, bile reflux gastritis, etc. Bile reflux can cause high total bile acids, but liver function is normal. (3) Biliary system diseases: such as bile duct stones, cholecystitis, cholangitis, etc., can lead to bile discharge is not unobstructed, so that bile reflux into the blood, causing high total bile acid, but liver function is normal. High total bile acid excludes physiological factors, need to consult a doctor in time to identify the cause and treatment.