PBC Foundation

Loose bowels on Urso. How long does it last?

Good afternoon from the USA, or night in the UK. I started URSO on Monday ( I take 1200 mgs daily) two in the morning and two at night. I seem to have tolerated pretty well so far. I have a hiatal hernia so I was concerned with acid reflux which I already treat. I knew I would probably have loose bowels at first while my body gets used to the dosage, but I was curious how long that lasts? If it is a constant issue, does taking a fiber supplement help. I had bowel issues years ago when I was on a med and the fiber helped.

I've had small amounts of heart burn that a zantac has helped for the most part.

Any thoughts?

14 Replies

Hello Notor, I take 900mg of urso, I take it all at once with my evening meal, I tolerate it well and have never had any problems with it.


Do you find it easier to take at once in the evening, since that is probably your bigger meal? I wonder if you tend to take it with a bigger meal of that is better.


Hi Notor, i take 750mg of urso, once daily with my dinner in the evening. When i was first put on urso, i was advised to start with one tablet and to build the dose up every couple of days.


Hi notor ,I take 2 in the morning with my breakfast and two with my evening meal I tolerate urso well just the occasional nausea feeling but soon settles .i know some people taking urso do suffer from loose bowels but usually settles down when the body gets use to it .i also have a hiatus hernia and take an antacid to counteract this ,works most of the time .


Hello NotorDJP.

Diarrhoea is one of the commonest side-effects of taking urso. For me I became the opposite. But for me I don't have a problem with bowels due to urso. I suffered temporary heartburn and a bit of bloating in the first few months of starting on urso. I persevered with the heartburn assuming it was the urso as I never had prior to taking, bloating either. On a manufacturer change of urso I did once again have heartburn for a short period of time. I found this time that taking a calcium with Vit D tablet vanished that and I thought better than any OTC meds for heartburn.

Now I'd not say that fibre supplements with diarrhoea may be a good idea somehow. But a doctor would be able to advise there. I think drinking more fluids and maintaining that might be of more help.

I know my theory from reading the patient leaflet here in the UK for the relevant meds, urso in this case, if one was take an overdose of urso and experience diarrhoea as the body just excretes what urso it doesn't require then perhaps some who do are on slightly more urso than their system requires. Same with some who experience constipation, could we be on slightly less urso than we require? My doctor at the hospital recommended me taking 10mgs per kg body weight daily. I had my weight rounded off to 60kgs (these days I am actually more like 55kgs) so take 600mgs daily.


I just sent my urso rx to the pharmacy, I am 53kg and now I know why I'm taking 500mgs daily. Do you think it's better to get 2- 250mgs and take twice a day. I start taking tomorrow and am tentative about side effects. Do you think it is better to start with 1/2 dose and work up to full dose as well? I will ask the pharmacy as well. Thank you for your helpful information. I think it was also you that said you think of it as a supplement not a drug, that is helpful thinking!


Hello normadawnreid.

I was originally asked to take the urso 4 times a day as I was to take 600mgs. I did tell the GP that I know I'd not take them at those intervals so I got them at 2 times a day. I did take one at breakfast and then one around 9p.m. in the early days. I then switched the 9p.m. tablet to just following evening meal.

Apparently it can be better taking the urso in divided doses to start with and I do think for myself that twice a day is by far better than taking them all at once. But as time goes on with urso I think it seems that everyone finds their own ideal. Some take them all at night, others at morning and some spaced out.

It seems to be said from the PBC Foundation on urso that as long as a patient is taking their daily mgs of urso then that is all well and fine.

I've experimented with mine since diagnosis Dec 2010 and find that for me taking it all at once of a morning with breakfast just caused me itching later in the morning which was unusual as I never do normally. I've not taken it all at night due to how I think I might be.

Hope you are fine. I just had a bit of heartburn and also bloating for the first few months but it vanished and I have been quite fine since. I would just make sure that you have just eaten or are eating when you take urso, I think that is wise.


Hi NotorDJP

I take 1500mg daily been on them since Jan 2011. I was initially prescribed URSO at 2 x 250mg 3 times a day. Like you at first I had diarrhoea but I had been pre-warned by my consultant. He advised me that if it did happen I was to cut the dosage back to 1 x 250mg 3 times a day until the diarrhoea subsided (it took about a week) then gradually reintroduce the tablets 1 at a time over the following month until I was back on the full dose again. I occasionally have the odd bout of diarrhoea still, I am never constipated (used to be before URSO) and my motions are always on the soft side. I also suffer with bloating and acid reflux.

Before being diagnosed with PBC I had never had to take regular medication and found it difficult to remember to take them so I have tried various combinations and timings over the last few years. I tried taking them all at once but the diarrhoea came back with a vengeance. I have now found that taking 3 x 250mg with breakfast and 3 x 250mg plus 20mg of Omeprazole for acid reflux/heartburn at around 6pm with my evening meal, this combination and pattern works fine for me.

Good luck and try to persevere.


Yup - had the loose bowel issue with the urso. When Cholestramine was added to my meds 10 days ago I began to have just the opposite so I don't know if the loose bowels would have went away on it's own in time.

I'm not sure which is worse......

I have read that one needs to be careful of the antacids that they take while on urso. Certain ones can make the urso less effective.


I have taken urso since feb last year I waited for the looseness but it never happened only occasionaly its more thick and sticky I take 1000mg daily with my evening meal


Hi Notor, I think it depends on your consultant, mine advocates taking urso in one go. I always make sure I have just eaten my food before I take them - even if it is just a sandwich.


Well after one day of loose bowels, not I am having borderline constipation. I am going but not as easily as I was. Crazy stuff!


After a few days now on the med i havent had any loose bowels but the one day. Not sure if that will change once i start my period as my bowels tend to be slow before my period. I have a couple of fibroids in my uterus that i am getting rechecked in another week. They tend to swell and cause me issues around my period. So far so good. Doing well on urso


I used to take 300mg a day but was reduced to 150 due to diarrhoea but still have problems 17 years later, sometimes really bad others not quite so bad, but I was told it is due to the disease as your body doesn't bulk out quickly enough before moving through the bowels.


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