The higher the ESR, the faster your RBCs settle at the bottom, indicating an intense inflammatory reaction. The inflammation can occur due to infections, injuries, including fractures, and even post-surgery. Furthermore, elevated ESR can also indicate other serious illnesses like arthritis, rheumatic fever, heart disease, vascular disease, certain types of cancer, inflammatory bowel disease, and kidney disorders. As mentioned earlier, certain medications can affect the ESR test result, for example, oral contraceptive pills. Also, during normal physiological conditions like menstruation or pregnancy, your ESR might be slightly high.