High direct bilirubin is less serious if it is caused by non-disease factors, such as medication and heavy alcohol consumption, but it can be more serious if it is caused by disease factors, such as liver disease and biliary tract disease, if it is not treated in time. 1. Non-disease factors: (1) Drug factors: if you take anti-tuberculosis drugs and other drugs with hepatotoxicity (such as rifampicin, etc.) due to illness, it may cause liver damage, affecting the normal metabolism of the liver, resulting in high direct bilirubin. (2) Drinking a lot of alcohol: Long-term drinking or drinking a lot of alcohol the day before the test can affect the liver, leading to high direct bilirubin. In this case, it can be normalized after stopping medication and alcohol consumption, and it is not serious at this time. 2. Disease factors: (1) Liver disease: If you suffer from hepatitis, liver cancer, cirrhosis and other diseases, liver cells can be damaged, resulting in high direct bilirubin, with or without fatigue, loss of appetite, jaundice, weight loss and other symptoms. (2) Biliary tract diseases: If the biliary tract is obstructed, the bilirubin will not be discharged smoothly, resulting in high direct bilirubin, which may be accompanied by pain in the right upper abdomen, chills, fever and other symptoms. At this time, if not treated in time, it may be serious. High direct bilirubin alone does not confirm the diagnosis of what kind of disease, it is recommended to consult a doctor in a timely manner, combined with routine blood tests, liver and gallbladder function tests and other test results, to identify and determine, the drug should be used under the guidance of a doctor.