Gastrointestinal endoscopy is an indispensable diagnostic and therapeutic procedure used in the management of numerous gastrointestinal disorders. Despite its clinical significance, patients frequently experience heightened psychological stress and procedural anxiety before and during endoscopic examinations. Elevated anxiety has been associated with increased salivary cortisol secretion, diminished patient cooperation, prolonged procedural duration, reduced procedural tolerance, and decreased willingness to undergo subsequent endoscopic evaluations. Consequently, identifying safe, inexpensive, and non-pharmacological interventions capable of minimizing anxiety has become an important area of clinical research. Among complementary therapeutic approaches, peppermint aromatherapy has emerged as a promising intervention because of its physiological calming effects, ease of administration, and minimal adverse reactions.

This research and review article critically evaluates the effectiveness of peppermint aromatherapy in reducing salivary cortisol concentrations and procedural anxiety among patients undergoing gastrointestinal endoscopy. Drawing exclusively upon the provided literature, the article synthesizes existing evidence regarding psychological determinants of endoscopic anxiety, patient preparation strategies, educational interventions, environmental modifications, and complementary relaxation techniques. Furthermore, a comprehensive methodological framework is proposed for evaluating clinical outcomes using standardized anxiety scales, physiological biomarkers, and patient satisfaction measures.

The review demonstrates that peppermint inhalation has substantial potential to reduce sympathetic nervous system activation, thereby decreasing cortisol secretion and improving psychological comfort before endoscopic procedures. Reduced anxiety contributes to better patient cooperation, improved procedural efficiency, and enhanced healthcare experiences. Although current literature supports several non-pharmacological anxiety-reduction interventions, evidence specifically examining peppermint aromatherapy remains comparatively limited, indicating an important opportunity for future randomized controlled investigations. The proposed framework integrates psychological assessment with physiological biomarkers to provide a multidimensional evaluation of intervention effectiveness while supporting evidence-based clinical practice.