Nerva App or Low FODMAP Diet Review

Today I'm answering the most popular question I've had these past 12 months, "Should I do the Nerva app or a low FODMAP diet and which works best for IBS"? As someone that's completed both approaches to tackling my IBS, I feel like I'm in a great position to review each method and help you decide.

Ad: This post is sponsored by Nerva, my go-to hypnotherapy app for IBS, but all words are my own.

Jump to:

• What is the Nerva app?
• How does the Nerva app work?
• What is gut-directed hypnotherapy?
• Does hypnotherapy work for IBS?
• How do I get started with Nerva?
• What is the low FODMAP diet?
• What are FODMAP's?
• How does the low FODMAP diet work?
• How do I get started with the low FODMAP diet?
• Which works best for me
• Do I have to choose?
• Is the Nerva app right for me?
• Is the Low FODMAP diet right for me?
• Video
• 10% discount off the Nerva app
• Comments

What is the Nerva app?

Nerva is a smartphone app designed to help you manage the symptoms of IBS. (Affiliate link). It offers you a way to access gut-directed hypnotherapy, in the comfort of home, without the cost or inconvenience of seeing a therapist in person, goodbye white coat anxiety.

The app was created in partnership with Dr Simone Peters who specialises in the impact of psychological therapies on gut disorders and symptoms. Dr Peters is also part of the Monash University FODMAP research team.

How does the Nerva app work?

The Nerva app works to retrain your gut/brain connection. The gut/brain connection is the complex link between our brain and the rest of our digestive system. This connection allows signals to pass directly back and forth, and if unbalanced, leads to the physical changes and symptoms we associate with IBS.

These signals are responsible for causing feelings of heightened sensations, anxiety and pain. Through positive suggestions, you can control how your gut feels and change how you respond to your condition.

Nerva delivers a structured 6-week gut-directed hypnotherapy program. The program includes daily guided hypnotherapy audios which are roughly 20 minutes long. Alongside the audio, are short reading tasks, breathing exercises and practical techniques you can work on in daily life.

The complete session takes less than 30 minutes a day. Throughout the 6-week program, the messages are reinforced through weekly repetition. Allowing you time to absorb the lessons and let everything sink in.

To get the most out of the app, you need to make time in your day to sit somewhere you can listen and relax into the sessions without being disturbed.

I've been using Nerva since 2020 and answered as many questions as possible about how it worked for me in my full review of the Nerva app post.

What is gut-directed hypnotherapy?

Gut-directed hypnotherapy uses specific suggestions and scenarios to balance the gut/brain connection. These improve digestion, reduce symptoms and encourage a mindset shift in how we view and cope with our gut issues.

During gut-directed hypnotherapy, you'll be guided into a relaxed but highly attentive, subconscious state. Once in this state of relaxation (hypnosis), the brain takes time out from its usual constant sensory overload. From this place of heightened awareness, we become more receptive to new ideas and positive suggestions.

These suggestions will often include visualisation, where you picture relaxing scenarios and positive outcomes associated with your condition. In the Nerva app specifically, you explore different settings like clearing away obstacles in a flowing river or (my personal favourite) dialling down your symptoms in a control room.

Does hypnotherapy work for IBS?

Although a limited area of research, there is growing evidence that gut-directed hypnotherapy works as a treatment for IBS.

Perhaps the study most relevant to this post was done in conjunction with Monash University and led by Dr Peters, the creator of Nerva. To the surprise of the research team, this randomised clinical trial showed gut-directed hypnotherapy to be as effective as the low FODMAP diet in controlling the symptoms of IBS.

Approximately 70% of patients across all groups reported improvements in overall symptoms. Hypnotherapy also outperformed a combination of both therapies or a low FODMAP diet alone at the 6-month follow-up.

In addition to the physical benefits, the patients receiving hypnotherapy also showed long-term improvement in anxiety and depression.

How do I get started with Nerva?

Nerva is suitable for anyone with a medical diagnosis of IBS. This is to ensure that your symptoms are not caused by other conditions. If you're unsure where to start, see my detailed articles on diagnosing IBS.

Working with Nerva doesn't require you to change your diet or restrict any foods. You don't need any additional appointments or consultations before starting. The entire program is delivered to your smartphone in short daily sessions.

Follow the link below to a short assessment to determine whether Nerva is right for you. If you decide to get started with the Nerva app, this affiliate link automatically activates your free 7-day trial and applies a 10% discount to the full price of the program. Winner winner!

What is the low FODMAP diet?

The low FODMAP diet is a strict elimination and reintroduction diet for treating the symptoms of IBS. By carefully eliminating excess FODMAPs from the diet and then reintroducing them one by one, we can see how our symptoms respond.

The low FODMAP diet as we know it today was created by the research dietitians at Monash University's gastroenterology department.

What are FODMAP's?

FODMAP is an acronym that stands for;

F = Fermentable

O = Oligosaccharides

D = Disaccharides 

M = Monosaccharides

A = And

P = Polyols

This acronym describes the process (fermentation) and different types of sugar molecules (saccharides) which can cause gut issues in some people.

Fodmaps are only found in carbohydrates. They are fermentable sugars in our diet that are poorly absorbed by the digestive system. Whilst we all typically digest these sugars in the same way, they can cause symptoms in people with IBS.

How does the low FODMAP diet work?

The diet works in 3 phases

1. Elimination
2. Reintroduction
3. Personalised

The elimination phase tests our response to FODMAPs in the diet. By minimising them, we can see how much of an effect they have on our IBS. If our symptoms improve throughout a 2-6 week elimination, we proceed to the next phase.

The reintroduction phase is where we carefully reintroduce the different FODMAPs back into the diet. By doing so in small, controlled amounts, we can see how we react. These reactions show us which FODMAPs we can tolerate and in what quantities. This phase typically lasts 8-12 weeks, depending on the frequency and intensity of our reactions.

The personalised phase uses the information learned so far to continue experimenting and expanding our long-term eating habits. Although it's important not to restrict foods long term this phase has no definitive timeline. Most people remain or return to this phase to keep their symptoms in check.

How do I get started with the low FODMAP diet?

The low FODMAP diet is approved for the treatment of patients with a medical diagnosis of IBS. The diet is complex and should only be followed under the supervision of a FODMAP-trained, registered dietitian.

Due to the restrictive nature of the diet, it's not suitable for everyone. At best, there's no evidence to show how safe or effective the diet is when going it alone. At worst, you are at risk of nutritional deficiencies and a disordered mindset around food.

Working with a specialist dietitian gives you the best chance of success and helps you to recognise and address any potential issues that may arise.

For those in the UK, getting a referral from your GP is the best place to begin. The low FODMAP diet is an approved method of treatment on the NHS but appointments and access can be limited.

If you're struggling to get a timely referral or you're outside the UK then the other option is to go private. These would typically be one-to-one appointments but increasingly, some dietitians are offering online sessions. Costs vary enormously depending on your location, availability and experience of the therapist.

Which works best for me

In the past, I've spoken in detail about my experiences of treating my IBS with the Nerva app. At the risk of repeating myself, today I'll try to keep things focused on comparing my experience with the Nerva app to that with the low FODMAP diet.

Cost

A side-by-side comparison is difficult, as many factors come into play based on your location and individual circumstances.

Time and convenience

This one is incredibly easy as in my opinion, there's no comparison to the ease of the Nerva app compared to the low FODMAP diet.

Nerva = 5/5

• Less than 30 minutes a day.
• No appointments, scheduling or travel.
• Can be done at any time that's convenient, usually in bed or on the couch in my pj's!

Low FODMAP Diet = ⅖

• 2 hours of travel to and from my initial appointment (I live semi-rural).
• 1-hour appointment with my dietitian.
• Several phone calls to reschedule dietitian appointments that had been cancelled or postponed by the NHS.
• An incalculable amount of time spent label reading, studying and double-checking food lists and the app, shopping and sourcing ingredients from various places.
• Initially lots of extra time each day to prep separate meals for me and my family. Once I'd got the hang of it and reduced this down, it was much quicker, but the first 8-weeks were tough!
• Roughly 30 minutes a day to fill out my daily food diary.

Eating habits

Nerva = ⅖

The Nerva program doesn't place any real emphasis on your diet because this is not a fundamental part of how gut-directed hypnotherapy works. The idea is that the techniques you learn to balance the gut and brain should work in most cases, regardless of triggers.

For many people, I imagine the lack of dietary changes is one of the biggest appeals of the Nerva app. However, as someone that did need to take a look at my eating habits and make improvements, I feel that Nerva could do better here. Whilst I understand that drastic changes are not required for the program to work, some basic pointers on eating habits would be helpful.

By the time I tried the Nerva app, I was eating my long-term personalised diet. This means I've reintroduced everything I cut out during the low FODMAP diet. My typical daily diet includes moderate to high amounts of all the FODMAP groups including, wheat, garlic, onions, beans and legumes.

Because I've pretty much learned to eat within my dietary limits through the low FODMAP diet, it's hard to say if or how Nerva would work for me in this area without this prior knowledge.

Low FODMAP Diet = ⅘

My eating habits and food choices were significantly changed by the low FODMAP diet. In hindsight, this was often for the better, as far as my gut was concerned. Although it can be very restrictive (particularly for vegans like me) I learned a lot of valuable information.

Whilst I always knew I wanted to reintroduce as many foods as possible back into my diet, I was happy to make certain habitual changes more permanent. Reducing my huge portion sizes was the biggest game-changer for me. I've always had a large appetite. The low FODMAP diet was the shakeup I needed to feel satisfied with less.

The low FODMAP diet also made me more regular with my meals, especially breakfast. I finally embraced the fact that eating late doesn't suit me and have stuck to a routine ever since.

I found comfort in knowing that I could reduce my symptoms with my food choices and eating habits. Something that I still use today, in a much less regimented way.

The downsides of low FODMAP food choices for me were the temporary restriction and increased cost.

Food mindset

Nerva = ⅘

One thing that did improve significantly was my food mindset. Although my diet had returned to normal before starting the Nerva app, I still had a lingering tendency to food blame and shame. This typically happened during troublesome symptoms when my first thought would be about what I'd eaten.

Through Nerva, I learned there's so much more to my condition and symptoms than what's happening on my plate. I became much more confident about eating out and thought about my food choices much less overall.

I realised that even if my symptoms tipped over into a full-on flare-up, I was able to cope. I felt more prepared to face my condition and take each meal, day and bowel movement, one at a time.

Low FODMAP Diet = ⅖

As someone fortunate in never having experienced seriously disordered thinking or behaviours around food, I consider myself very lucky. Looking back upon my time with the diet, I can see how it could easily create a negative food mentality.

Although I didn't notice any overly worrying behaviours in myself, I was aware of some low-level food anxiety. I also often found myself slipping into the good versus bad foods mindset. I regularly heard myself saying, "I can't eat that" or "It's not allowed". Neither of which are particularly healthy ways to think or feel about food.

Stress levels and mindset shifts

Nerva = 5/5

This is where Nerva shines! Stress reduction is a major factor in taking control of the sympathetic nervous system. The whole purpose of gut-directed hypnotherapy is to offer techniques that effectively encourage you to manage stress and be more resilient in coping with your condition.

These mindset shifts have been the biggest long-lasting benefit for me. They are by far the easiest and most effective way that I manage my IBS day to day.

My IBS has always been badly affected by stress, often more so than by food. Although I've tried everything from yoga, meditation and breathwork in the past nothing worked particularly well.

The framework and exercises that came with the Nerva app helped me understand why stress reduction was important and how it applies to me. I think this underpinning knowledge and getting into a routine of repetition made the biggest difference in finally taking control of my stress levels.

My stress and anxiety levels have reduced overall, which has had the knock-on effect of making my digestion and bowel habits much more predictable. So much so that even my hubby has noticed that I don't need to urgently "go" as often. (It must be love)!

The low FODMAP diet = ⅖

I can honestly say that the intensity and effort of the low FODMAP diet increased my overall stress levels.

• The steep learning curve that comes with navigating through each phase.
• Anxiety about whether I was doing it right.
• Worry about the long-term effects on my diet, relationship with food, family mealtimes and my gut microbiome.
• Avoiding or worrying about social eating throughout the diet.
• Logistics of shopping in multiple places and making multiple meals.

These were all huge stressors for me during the diet. Although learning about my food triggers was empowering, the whole thing could also be physically and mentally exhausting!

Overall effectiveness

Nerva = ⅘

The simple act of taking 30 minutes a day just to focus on me is one of the best gifts I've ever given myself. I enjoy listening to the audio sessions and look forward to actively working with, rather than against, my mind and gut.

I'm much more able to manage my condition and notice and defuse the stress/symptom cycle before it takes over. Whilst my anxious tendencies have never gone away, recognising them more easily gives me the chance to act rather than react.

It's been just over a year since I first began my journey with Nerva. I can honestly say it will continue to be part of my long-term IBS treatment plan for the foreseeable future.

For me, the overall effectiveness of gut hypnotherapy comes with continuing to consciously apply the techniques to any given situation. I didn't expect a miracle cure when I began but I seriously underestimated what it could do for me long term.

Low FODMAP Diet = ⅗

I think it's safe to say that I have a love/loathe relationship with the low FODMAP diet.

I've learned a wealth of new skills and embraced new recipes, ingredients and cuisines. I can pretty much predict how I'll feel based on what I eat. Whilst it's given me so much practical knowledge that I can apply to avoid major flare-ups, it's also very one-dimensional.

You're forced to become creative with your cooking, develop world-class label reading skills, pay attention to portion sizes and try new things. But force is precisely the right word. Most of the time you're acting out of desperate necessity rather than free will.

Diet is one aspect of my condition. The further I stray from it the more I see how much more there is to my IBS than what's on my plate.

I'm forever grateful for the connections and community it's brought me online. I'll continue to support those working through the diet in every way I can in the future.

Now that we've seen the major differences between these treatments and how they work, how do you decide which is right for you? I imagine you already have an inkling of which one might suit you best. Before you decide, ask yourself these questions.

Is the Nerva app right for me?

If you answer yes to the following questions, then you may benefit from gut-directed hypnotherapy via the Nerva app:

• Do you own a smart device capable of downloading and running apps?
• Can you find 30 minutes a day to sit undisturbed?
• Would you prefer the idea of tackling your symptoms without changing the way you eat?
• Are you motivated enough to progress through a self-directed course of treatment without attending appointments or being held accountable by an in-person therapist?
• Does stress, anxiety, excitement or a change of routine have an impact on your symptoms?
• Do you feel that you can get away with eating and tolerating your trigger foods as long as you’re relaxed and happy? 
• In times of stress, do you flare up no matter what or how you eat?
• Do you have limited time for cooking, rely on processed and packaged foods or prefer routine and familiarity when it comes to what you eat?
• Are you already eating a restricted diet and worry that cutting out more foods could lead to malnutrition or health issues?
• Would you say you love your food, regularly enjoy eating out and hate being told what you can and can’t eat? 
• Have you previously looked at the low FODMAP diet and thought, “No way!” Maybe you’ve tried it and struggled or didn’t experience any relief.
• Do you have a history of disordered eating or triggering thoughts around food?
• Have you previously been told that a low FODMAP diet is not advised for you? Is there a chance it may negatively affect your mental or physical health?
• Is someone other than you responsible for planning, buying and cooking the majority of your meals?

If this resonates with you then you might be better suited to tackling your symptoms with the Nerva hypnotherapy app.

Is the Low FODMAP diet right for me?

If you answer yes to the following questions, then you may benefit from a low FODMAP diet:

• Do you have access to a FODMAP-trained dietitian? Can you budget for a minimum of three appointments, with additional sessions if needed?
• Have you attempted to go it alone in the past with poor results? Do you need to be held accountable to stick to a treatment plan?
• Do you eat a lot of high FODMAP foods in a typical week? Such as wheat, onions, garlic, beans, peas, brassica vegetables, dried or stoned fruit and sweeteners (such as agave, high fructose syrup, honey, xylitol, sorbitol, mannitol, maltitol and isomalt).
• Are you already restricting or avoiding certain foods because you don’t know what’s safe to eat?
• Do you get anxious about food shopping, eating out or eating away from home? Does it worry you, not knowing what to choose or how it’ll make you feel?
• You know that your eating habits, skipping meals and portion sizes tend to hurt your gut and could do with some attention? 
• Do you enjoy spending time food shopping, cooking, meal prepping and experimenting with new ways of cooking familiar meals?
• Are you the main cook in your household? Is the majority of meal planning, shopping and cooking, usually your responsibility?

If you feel that most of the points above best describe you, then it may be time to discuss the possibility of trying a low FODMAP diet with your doctor.

I came up with these questions to get you thinking about your options. I’m not a medical professional and cannot personally recommend one course of treatment above another. Always discuss any significant changes or treatment options with your doctor before changing your diet or paying for treatment programs.