Good evening, Firewolf531!! The effect of this medication that Tasha is taking can be severe. Your stomach/intestines are in place to digest food properly without any harm to the body. If she takes this medicine on an empty stomach, she will have acid reflux. Acid reflux is whenever your esophagus/stomach basically digests itself because there is not any food there to digest. It is very painful and common along many people. Whenever you see a medication say on the back, "Do not digest on an empty stomach," this is because the stomach and esophagus will eat away, causing pain. There are surgeries in place for whenever this happens, but usually cannot be fixed by one surgery. I hope this helps!! Have a great day.