Scope Forward

In this episode of The Scope Forward Show, Praveen Suthrum speaks with Alex Noumidis, Co-founder and CEO of Nerva, a digital therapeutic platform for IBS (Irritable Bowel Syndrome) and other disorders of gut-brain interaction. They discuss the origins of Nerva, the science of psychophysiology, digital health adoption in GI, and the challenges of bringing behavioral therapies into mainstream gastroenterology. The conversation dives deep into the power of gut-directed hypnotherapy, its clinical validation, the bottlenecks in scaling access to GI psychology, and what it takes to build a product that patients actually use. They've seen 300,000 patients and plan to expand to all GI conditions. Recorded between Australia and Mumbai, this global conversation also reflects on the evolving landscape of GI care.* 🔹 Key Insights from the Interview 03:08 - Personal Experience Sparked the IdeaAlex’s misdiagnosis with IBS and later discovery of celiac disease gave him a personal window into the patient journey. That experience, combined with limited access to GI psychologists, led to the creation of Nerva a digital solution to scale gut-directed hypnotherapy. 04:16 Low Supply, High DemandThere are only 400 GI psychologists in the US, for tens of millions of patients. This scarcity makes traditional referral-based behavioral therapy unscalable, underscoring the need for digital solutions. 05:31 - What is Psychophysiology?Psychophysiology is the study of how the mind influences the body—how thoughts and emotions can affect physical symptoms. Nerva is grounded in this field, using it to treat functional GI disorders digitally. 06:56 - Evidence Behind Gut-Directed HypnotherapyNerva’s Chief Medical Officer, Dr. Simone Peters, conducted a landmark RCT at Monash University comparing gut-directed hypnotherapy to the low FODMAP diet. Both were equally effective—except hypnotherapy didn’t require dietary changes. This gave clinical backing to Nerva’s model. 11:13 - Nerva’s Impact and PositionWhile other digital competitors (like Mahana and Bold Health) have shut down, Nerva remains the only at-scale digital brain-gut therapy platform for IBS. They've already helped over 300,000 patients, mostly in the US, and are now expanding into other functional GI conditions. 18:38 - Adherence = EfficacyAlex highlights a critical learning: “Efficacy is partially adherence.” Many digital products fail because patients stop using them. Nerva focused deeply on engagement and user experience, ensuring that people stick with the program, thus improving outcomes. 25:06 - The Biopsychosocial Model in IBSGI is shifting from a diagnosis of exclusion to a diagnosis of inclusion, using Rome Criteria. Treatments now span:* Diet (FODMAP)* Medications (Linzess, etc.)* Behavioral (CBT, hypnotherapy)Nerva fits squarely in this new behavioral frontier. 40:14 - Barriers to Clinical AdoptionDespite strong evidence, GI providers are slow to adopt brain-gut therapies. Reasons include:* Lack of nearby GI psychologists* Long waitlists* Clinical guidelines placing behavioral therapies late in the treatment pathway.* Skepticism or unfamiliarity among providers 47:11 - Future of GI Behavioral HealthThere’s a growing push—backed by AGA’s 2025 quality indicators—to recognize and reimburse digital brain-gut therapies. But for this to happen at scale, digital platforms must prove clinical efficacy, economic value, and user adherence. Nerva’s model appears well positioned. *#digitalhealth #gastroenterology #thescopeforwardshow #nextservices #gi #future #ai #theshift #gut-brain axis