Urso has a synthetic acid as one of the ingredients in it. You really need to take Urso with some food of some sort, so that it has something in your stomach to help break that acid down. PBC is also a digest disease because of the flow of bile that isn’t getting through your Liver. The Liver is the uppermost section of your digestive system.
I was in the dosage study in the 90’s for Urso. That was one of the first things they said was vitally imperative. When we started that study we were all taking 10 - 250mg
Pills a day.
We learned right away the reason why to “take with food”.
Please take this advice to heart. As Liver patients we all suffer with some king of digestive issues. It’s a very common symptom. This is a simple fix for some of those issues.
JeanAZ

I take mine with or without.

I take mine first thing in the morning as well, and bedtime, no tummy issues. Doctor never told me to make sure I took with food

I also take in the morning and then before bed. Its easier to remember to take. I've haven't had any tummy issues. I've been taking it for almost 15 years

I take it first thing in morning. And going to bed. Originally I had stomach aches but they've settled down.Been on since March. M y numbers have improved greatly!