Options for Receiving Communion for those with Celiac Disease

Brothers and Sisters,

One great difficulty faced by some of our brothers and sisters is Celiac Disease, “an immune reaction to eating gluten, a protein found in wheat, barley, and rye. For those with the disease, eating gluten triggers an immune response in the small intestine. Over time, this immune reaction damages the small intestine’s lining and hinders absorption of some nutrients. The intestinal damage often causes stomach pain, diarrhea, and weight loss, and can lead to serious complications. A Mayo Clinic-led analysis published in 2012 estimates that roughly 1.8 million Americans have the disease, but around 1.4 million of them are unaware that they have it” (see https://www.usccb.org/prayer-and-worship/the-mass/order-of-mass/liturgy-of-the-eucharist/celiac-disease-and-alcohol-intolerance).

The Catholic Eucharist can be brought about by the sacramental transformation only of true bread made from wheat (and not any other grain). For this reason, the bread to be consecrated must must include at least a small amount of gluten to truly become the Body of Christ. Thus, “no-gluten” hosts cannot possibly be consecrated and become the Body of Christ. All of this becomes a significant possible obstacle for a sufferer of Celiac Disease who wants to receive Holy Communion.

Why this need for at least a small amount of gluten? From the earliest times of the Catholic Church, she has always taught that for Holy Communion to be “valid” (i.e., to truly be the Body, Blood, soul and divinity of Jesus Christ, and not just a symbol of Christ’s presence), the priest must do “what Jesus Himself did” at the Last Supper. Already in 253 a.d., in the midst of intense persecution, some priests were substituting water for wine in the early morning Eucharist because after Mass, their people were being revealed as Christians because of the smell of wine on their breath. In response to this use of water, the Church Father St. Cyprian (bishop of Carthage in N. Africa, who was also martyred in this same persecution) ruled that the use of water rather than wine in the Eucharist was invalid and must be stopped, because it departed from Jesus’ teaching, by failing to do what the Lord “both taught and did.” He wrote that

[t]he blessed Apostle Paul … lays down … in his epistle, saying, “The Lord Jesus, the same night in which He was betrayed, took bread; and when He had given thanks, he broke it, and said, This is my body, which shall be given for you: do this in remembrance of me. After the same manner also He took the cup, when he had supped, saying, This cup is the New Covenant in my blood: do this, as often as you drink it, in remembrance of me. For as often as you eat this bread and drink this cup, you shall show forth the Lord’s death until He come” (1 Cor 11:23-26). But if it is both enjoined by the Lord, and the same thing is confirmed and delivered by His apostle, that as often as we drink, we do in remembrance of the Lord the same thing which the Lord also did, we find that what was commanded is not observed by us, unless we also do what the Lord did; and that mixing the Lord’s cup in like manner we do not depart from the divine teaching; but that we must not at all depart from the Gospel precepts, and that disciples ought also to observe and to do the same things which the Master both taught and did. (Gal 1:6-9). (St. Cyprian Ep 62.10)

This same principle – that we could do and say only what Christ did and said in the transformation of wine into His blood – was applied also to the transformation of true bread made from wheat into His Body. Skipping over the history, we can see most recently, in the 20th century, the Church’s same teaching, even in the context of the discovery of Celiac disease. In our times, the Church has many times reaffirmed her teaching that the Holy Eucharist can be confected (or “brought about”) only from true bread made from wheat. Since true bread made from wheat must contain at least some fraction of gluten, gluten-free bread cannot be used to confect the Eucharist. How much gluten must be present? The answer has been given to be .01%, [=.0001] or 1 part per 10,000 (see Merdian, Ethics & Medics, below).

What, then, is a Catholic with celiac disease to do? The first and simplest possible recourse for such a person is to see that one’s priest obtains “low gluten” hosts (hosts of under 1 part per 10,000) to be consecrated at Mass (again, “no gluten” hosts cannot become the Body of Christ). In most cases of gluten sensitivity, “low gluten hosts” cause no problem. But in cases of strong or extreme gluten sensitivity (full Celiac Disease), using such hosts can cause strong or even extreme reactions.

In such extreme cases, there are 3 further options beyond low-gluten hosts. The first is to receive only the smallest fragment of a low-gluten host. A second possibility would be to partake of the Precious Blood. A 3rd option could be used for people such as alcoholic priests for whom the latter would result in problems. In cases like this, the Church has granted some priests “indults” (special exceptions) to allow them to consecrate “mustum” (grape juice which has been allowed to ferment only a small bit). As knowledge about Celiac Disease has spread, the Church has extended this use of mustum also to the laity with Celiac Disease who cannot partake of the Sacred Host. Any of these three exceptions can be allowed to all of us in this parish.

If any of these apply to you, please let one of the priests here know so that we can make it possible for you to receive communion at any of our Masses. Depending on your condition, we can work out with you the particular means by which we can minister to you the Lord’s Body and/or Blood.more 

For those who wish to research these matters in more detail, see the following articles.

“Celiac Disease and Holy Communion,” Msgr. Mark J. Merdian, M.A. Ethics & Medics,” A Commentary of The National Catholic Bioethics Center on Health Care and the Life Sciences. Nov. 2012, Vol. 37, Number 11.

See: Ethics and Medics.

USCCB (United States Conference of Catholic Bishops): “Celiac Disease, Alcohol Intolerance, and the Church’s Pastoral Response,” From the Committee on Divine Worship Newsletter, October 2012 (updated April 20, 2016) © 2012-2016, United States Conference of Catholic Bishops. See: 


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