People with gut-brain disorders
Your pain is real, and it isn't in your head. It's in the wiring between your gut and brain, and that wiring can be retrained.
Start free assessmentMechanism of action
The pain is real.
The alarm is set too sensitive.
In gut-brain disorders like IBS, sensitive gut nerves and an on-alert brain keep setting each other off. Gut-brain therapy helps retrain that loop.
You already know your gut and brain are connected
Butterflies before a big moment
Nerves show up in your stomach before they show up anywhere else.
Rushing to the bathroom when you're anxious
Stress can speed up your gut within minutes.
Your stomach dropping at bad news
Your brain reacts, and your gut reacts with it.
That two-way line is the gut-brain axis. Its main cable, the vagus nerve, mostly carries messages upward: about 80 to 90% of its fibers carry signals up to the brain, not down.1
In gut-brain disorders, the alarm is set too sensitive
The science
Visceral hypersensitivity
Overly sensitive nerves in your gut send alarm signals to the brain that something is wrong, even when nothing is damaged. Bloating, urgency or pain after eating can all be that alarm going off.
Think of a smoke alarm set too sensitive. It goes off when you make toast. The alarm is real and so is the noise, but there is no fire.
- Normal digestion sends a signal, like gas or stretch.
- Sensitive gut nerves turn that signal up.
- The brain reads danger and goes on alert.
- Stress makes the gut more reactive, and the loop repeats.
Why tests often come back normal
Scopes and scans look for damaged tissue. In gut-brain disorders such as IBS, functional dyspepsia and functional constipation, the tissue is usually fine; the problem is how the gut and brain talk to each other. That is why pain can carry on after a normal workup, and why your doctor rules out other causes first.
The balloon test: same gut, a calmer response
To measure visceral hypersensitivity, researchers gently inflate a small balloon in the lower bowel and ask when it starts to hurt. Many people with IBS feel pain at volumes that people without IBS barely notice.
After 12 weeks of gut-directed hypnotherapy, people with IBS who were over-sensitive could take more inflation before it hurt, moving toward the normal range. Normal sensation stayed the same.2 An earlier study found the same shift, clearest in diarrhea-predominant IBS.3
Brain scans show a similar shift. People who responded to psychological therapy, including hypnotherapy, showed a calmer brain response to the balloon, closer to that of people without IBS.4
Comfortable
IBS, before therapy
Comfortable
After gut-directed hypnotherapy
Comfortable
No IBS
Schematic, not study data. Based on Lea et al. 2003 (23 people with IBS and 17 healthy volunteers) and Prior et al. 1990 (15 treated, 15 untreated controls).
How gut-brain therapy works
Central pain processing
The brain's pain and emotion networks turn gut signals up. Brain-scan research tracks how this response calms with psychological therapy.4
Hypervigilance
The brain stays on high alert, scanning the gut for trouble. In CBT research, easing fear and avoidance of gut sensations was a key reason people improved.5
Visceral hypersensitivity
Sensitive gut nerves raise the alarm at normal levels of gas and stretch. After gut-directed hypnotherapy, that sensitivity moved toward normal.2
Pain outcomes in Nerva's trial
In a randomized trial in IBS, 71% of people using Nerva had at least a 30% drop in abdominal pain, compared with 35% on an active control.6
Fight-or-flight response
Stress and strong emotion put the body on alert. In a lab study of people with IBS, anger made the gut more sensitive and relaxation made it less.7
Vagus nerve
The main line between brain and gut. Slow belly breathing is used to engage the body's “rest and digest” system.1
Reframing
Guided imagery and suggestion help people practice reading gut sensations as safe, not as a sign that something is wrong.
What Nerva teaches
Gut-directed hypnotherapy
Not stage hypnosis. A guided, gut-focused relaxation therapy, included in GI guidelines8 and expert reviews,9 that teaches the brain to read gut signals as safe.
Cognitive behavioral therapy (CBT)
Practical skills that break the cycle of worry and avoidance around gut sensations.
Diaphragmatic breathing
Slow belly breathing that engages the body's “rest and digest” system.
Inside a hypnotherapy session
Hypnotic induction
A guided relaxation settles the body into a calm, focused state.
Guided visualization
Gut-focused imagery, like a calm river or warm light, helps you practice feeling gut sensations as safe.
Gut suggestions
Calming, gut-specific suggestions are repeated across sessions, so the calmer response becomes familiar.
Hypnotic induction
A guided relaxation settles the body into a calm, focused state.
Guided visualization
Gut-focused imagery, like a calm river or warm light, helps you practice feeling gut sensations as safe.
Gut suggestions
Calming, gut-specific suggestions are repeated across sessions, so the calmer response becomes familiar.
- 6 weeks
- 15 minutes a day
- On your phone
- Alongside your usual care
The evidence
Tested in a randomized controlled trial
In a trial of 244 adults with IBS, published in The American Journal of Gastroenterology, the Nerva program was compared with the same daily digital program without gut-directed hypnotherapy. After 6 weeks, 81% of people using Nerva had a clinically meaningful improvement on the IBS Symptom Severity Scale, compared with 63% on the control. Results were maintained at 6 months.6
Beyond IBS
Gut-directed hypnotherapy has also been tested in functional dyspepsia. In a randomized trial, people who had it were less likely to start new medication over the following year and saw their doctors less often.10 Nerva's own published trial is in IBS, and research in other gut-brain disorders is under way.
What this means for you
Clinicians
Gut-directed hypnotherapy and CBT skills that target visceral hypersensitivity and gut-brain signaling, with randomized trial evidence in IBS. Refer by link, or add our EMR smart phrase from the FAQ below.
Refer a patientHealth plans and employers
After a normal workup, many people with gut-brain disorders keep returning for tests and visits that cannot find a structural cause. Nerva adds a brain-gut therapy included in GI guidelines, delivered by software at population scale and measured with validated scores.
Get in touch with a clinical specialist
Send an inquiry or book a brief call with our clinical team to discuss Nerva, referral options, EMR integration, or to organize a lunch and learn for your clinic.
Emily Mahadeo
Doctor of Clinical Nutrition (DCN) & Registered Dietitian Nutritionist (RDN)
Your questions,
answered.
What is the cost of the program?
The standard public Nerva offer is an annual subscription: $199 USD, A$249 AUD, €199 EUR or £149 GBP for 12 months of access. Patients referred by their healthcare practitioner receive a 25% discount. App stores may show other product names or offers, but the standard offer for new customers is annual.
Patients begin with a 7-day free trial to explore the program risk-free. For added peace of mind, we also offer a 42-day money-back guarantee.
Who is suitable for Nerva?
Nerva is for adults with a diagnosed gut-brain disorder (also called a disorder of gut-brain interaction, or DGBI), such as IBS, including the constipation (IBS-C), diarrhea (IBS-D) and mixed (IBS-M) subtypes, or functional dyspepsia. A short assessment checks whether Nerva is a good fit. IBS is where the evidence is strongest.
Many people who use it are managing gut-related stress, looking for a non-pharmacological, non-dietary option, or haven't found relief with approaches they've tried.
Who should not use Nerva: it is not recommended for individuals with severe psychiatric disorders, unresolved psychological trauma, or cognitive impairments.
For an in-depth guide, see our decision tool.
Is Nerva only for IBS?
No. Nerva works on the gut-brain connection behind disorders of gut-brain interaction (DGBIs), such as functional dyspepsia and functional constipation as well as IBS. IBS has the strongest evidence, including Nerva's randomized controlled trial, and research in other gut-brain disorders is under way.
A clinician should confirm the diagnosis first, and a short assessment checks whether Nerva is a good fit.
What is gut-directed hypnotherapy?
Gut-directed hypnotherapy (GDH) is a psychological therapy that works on the gut-brain connection. It guides you into a state of focused attention, where you become more receptive to calming, gut-focused suggestions, shifting the body out of a stress response and into a state of calm.
During hypnosis, we can observe physiological changes in brain activity related to absorption, executive control, and awareness.
With self-hypnosis, you can practice anytime, anywhere, without an in-person hypnotherapist, while remaining in complete control.
Can I access patient results?
Yes, patients can choose to add your details, allowing you to receive progress updates and reports with the self-reported IBS-SSS and PHQ-4 check-ins they share. These insights are securely delivered through our HIPAA-compliant and Australian Privacy Principles-compliant reporting system.
Can I test the app as a practitioner?
Yes, we offer free clinician access, allowing you to explore the full Nerva program firsthand. This gives you insight into the structure, content, and experience your patients will have.
How long is the program?
Nerva follows a structured 6-week program built on gut-brain therapy techniques, in 15 minutes a day.
To support long-term self-management, patients receive a 12-month subscription, which includes ongoing access to our flare-up toolkit for maintenance and support whenever they need it.
Do you have a smart phrase template I can add to my EMR?
Here is a smart phrase template that's worked well for other practices when adding Nerva to discharge instructions:
I’m referring you to Nerva, an evidence-based gut-brain program for IBS and other gut-brain disorders. In a randomized controlled trial in IBS, 81% of participants reported significant improvement in symptom management over the 6-week program. Visit: www.nervahealth.com
- Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9, 44. https://doi.org/10.3389/fpsyt.2018.00044
- Lea, R., Houghton, L. A., Calvert, E. L., Larder, S., Gonsalkorale, W. M., Whelan, V., … Whorwell, P. J. (2003). Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 17(5), 635–642. https://doi.org/10.1046/j.1365-2036.2003.01486.x
- Prior, A., Colgan, S. M., & Whorwell, P. J. (1990). Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut, 31(8), 896–898. https://doi.org/10.1136/gut.31.8.896
- Lowén, M. B. O., Mayer, E. A., Sjöberg, M., Tillisch, K., Naliboff, B., Labus, J., … Walter, S. A. (2013). Effect of hypnotherapy and educational intervention on brain response to visceral stimulus in the irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 37(12), 1184–1197. https://doi.org/10.1111/apt.12319
- Hesser, H., Hedman-Lagerlöf, E., Andersson, E., Lindfors, P., & Ljótsson, B. (2018). How does exposure therapy work? A comparison between generic and gastrointestinal anxiety-specific mediators in a dismantling study of exposure therapy for irritable bowel syndrome. Journal of Consulting and Clinical Psychology, 86(3), 254–267. https://doi.org/10.1037/ccp0000273
- Anderson, E. J., Peters, S. L., Gibson, P. R., & Halmos, E. P. (2025). Comparison of digitally delivered gut-directed hypnotherapy program with an active control for irritable bowel syndrome. The American Journal of Gastroenterology, 120(2), 440–448. https://doi.org/10.14309/ajg.0000000000002921
- Houghton, L. A., Calvert, E. L., Jackson, N. A., Cooper, P., & Whorwell, P. J. (2002). Visceral sensation and emotion: A study using hypnosis. Gut, 51(5), 701–704. https://doi.org/10.1136/gut.51.5.701
- Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., & Moshiree, B. (2021). ACG clinical guideline: Management of irritable bowel syndrome. The American Journal of Gastroenterology, 116(1), 17–44. https://doi.org/10.14309/ajg.0000000000001036
- Chey, W. D., Keefer, L., Whelan, K., & Gibson, P. R. (2021). Behavioral and diet therapies in integrated care for patients with irritable bowel syndrome. Gastroenterology, 160(1), 47–62. https://doi.org/10.1053/j.gastro.2020.06.099
- Calvert, E. L., Houghton, L. A., Cooper, P., Morris, J., & Whorwell, P. J. (2002). Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology, 123(6), 1778–1785. https://doi.org/10.1053/gast.2002.37071