[alexnaoumidis]

Great question! The approach used in the study also used psychoeducation and breathing exercises as well and we’re in the early stages of an observational study into the Nerva program. What do you mean re discouraging users who’ve tried FODMAP?

[graeme]

I read their comment as perhaps meaning that the study showed fodmap + hypnotherapy was no more effective than fodmap + hypnotherapy. A result I found surprising. (Unless it means the problem was effectively solved in both case, so no more improvement was possible)

[alexnaoumidis]

Ahhh I understand - that’s a good point. Many people follow the low FODMAP diet without the direction of a dietitian (against the recommendation on how to do it) and likely aren’t getting the full result so GDH will still provide benefit, as well as helping the psychological side of IBS.

Interestingly, it’s possible they both help with visceral hypersensitivity - FODMAPs ferment in your gut causing gas and your gut to expand and hypersensitive nerves could then be alerting the brain to potential (but false) danger, so by avoid FODMAPs you avoid this process. Hypnotherapy could potentially be coming at the same process but from the top down instead.

[graeme]

Yeah. Your final point could be true if both interventions fully resolved the issue, or at least as much as could be done. If not, it’s puzzling the combo didn’t lead to more improvement.

But certainly I don’t see it as a cause to exclude low fodmap people from trying the app.

[graeme]

Do you have a link to the studies on ibs being caused by hypersensitive nerves? Just going through onboarding in the app and was curious about that.

[alexnaoumidis]

Yeah, no worries you can read a study about the role of visceral hypersensitivity in IBS here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056566/