Office for Worship and Spiritual Life

Pastoral Guidelines for the Use of Low-Gluten Hosts by those with Celiac Disease

The Office for Worship receives many inquiries about the necessity of using wheat flour for the host in the celebration of the Eucharist.  This particular concern reflects the growing recognition of a very serious disorder called celiac disease. Celiac disease results in a harmful intestinal reaction to the gliadin in the gluten in wheat and other grains. The gluten in wheat flour is a protein complex that functions to bind the bread as it is made.  Gluten must not be ingested by persons with the disease because serious damage to the digestive system may result.  The damage inhibits the absorption of vitamins and nutrients, and predisposes its victims to osteoporosis, neurological illnesses, and even lymphoma.  Some other grains, such as rice, do not pose this danger.

Based on the seriousness of this disease it is understandable why people might question the Church's teaching on the necessity of using only wheat bread for the Eucharist.  Is this not simply a man-made rule that can be set aside for the pastoral needs of those who suffer this disorder?  Unfortunately, it is not that simple.  The Church's use of wheat for the eucharistic bread has roots deep in the Church's tradition both east and west. 

The tradition begins with Jesus who at the last supper used wheat bread and wine made from grapes.  He gave his command: "do this in memory of me."  The Church has kept this command ever since as she has celebrated the Eucharist and, like Christ, has only used wheat bread and grape wine.  The Church teaching has consistently been that it has no authority to change what Christ instituted.  Although it is not possible here to give a full scriptural and historical examination of this practice, the Church believes that the use of bread made of wheat is of divine origins. 

            One is then left with the question of how to address this serious problem of people with celiac disease.  Gluten is naturally present in wheat flour and a principal binding agent in the formation of true bread. And, a host without some amount of gluten present is not considered valid matter for the eucharist. What can be done for those with celiac?  A solution to this problem may now exist.  The Congregation for the Doctrine of the Faith has given approval for the use of low-gluten hosts (Prot. 89/78-174 98).  A very low-gluten host has been developed by the Congregation of Benedictine Sisters of Perpetual Adoration in Missouri.  Some consider this confection to be safe for use by those with celiac disease.  The valid use of these hosts has been attested to by the Bishops' Committee on the Liturgy in their November 2003 Newsletter.  In an article written in Gluten-Free Living (Vol. 9 no. 2, 2004) Ann Whelen quotes Carlo Catassi, MD, who is an expert in celiac disease, concerning the amount of gluten contained in these hosts.  The article states: "Of the hosts Dr. Catassi said, 'This dose would have no clinical or histological effect even if taken on a regular basis.'"  In this limited space it is not possible to present the science to support this statement but it is contained in two articles in Gluten-Free Living (Vol. 9 no. 1, 2004), the first by Sister Jeanne Crowe, "Catholic Celiacs Can Now Receive Communion," and the second by Ann Whelen, "Make your own decision." A follow-up article is also by Ann Whelen, "Low-Gluten, no gluten" (Vol. 9 no. 2, 2004).  It is of course important to remember that when dealing with any medical issues, particularly ones that may have serious consequences, it is appropriate to encourage the person to seek proper medical advice from an individual's own physician.  In presenting this information there is no intention to render a medical opinion for what someone with Celiac disease should do. If you are interested in reading these articles I am working with Gluten-Free Living to be able to place them on our website.

            It is possible that those with this disorder may still not agree that receiving this host would be a safe practice for them.  It always remains possible for them to receive only from the cup.  Our theology teaches us that we receive in one element of the Eucharist what we receive wholly and completely in the other.  In either species of the Eucharist we receive the whole Christ, in his Body and Blood, soul and divinity.  As a further precaution it might be advisable to set aside a cup for the exclusive use of those with celiac disease so that there is a diminished chance of contamination with gluten from others who receive both the host and from the cup.  Other practical liturgical issues will need to be attended to when permission is received.  It is not possible to address those concerns here; rather when permission is received guidelines will be sent on how best to handle the situation.

            The use of low-gluten hosts and the use of mustum are restricted to individuals who have a medical need and have been granted permission to use them.  Furthermore, the use of mustum is reserved to those who are incapable of receiving a host and cannot receive alcohol.  Therefore, the use of low-gluten hosts and mustum by individuals without permission is not allowed.  Thus, they are not to be used by the congregation as a whole but rather are restricted only to those who have received the Archbishop's permission.  If the use of these hosts or the use of mustum is already occurring in a parish it is important to seek the permission for their continued use.  If a parishioner desires to receive such permission please have the parish priest contact either Reverend Brian Mahoney, Director of the Office for Worship at 617-746-5880 or Reverend Mark O'Connell, Assistant to the Moderator of the Curia for Canonical Affairs at 617-746-5650.  When permission is granted to the individual they will receive a letter granting permission, a certificate that they may bring with them to other parishes to show that the permission has been granted for such use plus instructions on what to do when receiving communion outside of their home parish. 

Also, included with this letter is a sheet of frequently asked questions and a short answer for each one, and a form for requesting permission for those seeking to use low-gluten hosts or mustum.  If you have any further questions please do not hesitate to get in touch with the Office for Worship.

Highlight of Procedures

for Permission to Use Low-Gluten Hosts or Mustum

A Short Introduction to Holy Communion and Celiac Sprue Disease

What is Celiac Sprue disease?

In recent years, many have worked to foster an increasing awareness of the significant effects of Celiac Sprue disease on people's lives.  The digestive system of those with this condition is considerably compromised by the consumption of gluten, one of the major ingredients in wheat flour.  It is estimated that as many as fifteen percent of all persons of northern European origin are affected by this disease to some degree.

How does this affect those who go to Holy Communion?

This is a particular challenge to Catholics, who believe that the celebration of the Holy Eucharist and the reception of Holy Communion are the very source and summit of Christian life.  Priests should show great pastoral sensitivity and compassion to anyone afflicted with this disease, but especially to the parents of children with a gluten intolerance at the time of their first Holy Communion.

Can low gluten hosts be used at Mass?

The Secretariat for the Liturgy of the U.S. Bishops' Conference has devoted considerable resources to this question for the last seven years.  Within the past year, the Secretariat has successfully assisted the Congregation of Benedictine Sisters of Perpetual Adoration in Clyde Missouri in the production of a very low-gluten host which has been favorably reviewed by the publication Gluten-Free Living as "perfectly safe"[1] for sufferers of Celiac Sprue disease.

Where can I buy these low gluten hosts?

Low gluten altar hosts are available from: the Congregation of Benedictine Sisters of Perpetual Adoration, Altar Breads Department, 31970 State Highway P, Clyde, Missouri 64432 (Phone: 1-800-223-2772, e-mail: altarbreads@benedictinesisters.org).

What if a person cannot consume low gluten hosts?

Such communicants may still receive the Precious Blood.  Catholics believe that whoever receives Holy Communion only under the form of bread or only under the form of wine still receives the whole Christ, in his Body and Blood, soul and divinity.

What about people who cannot receive low gluten hosts and cannot receive even a small amount of consecrated wine?

In such cases, the bishop may grant permission for individuals to receive mustum, a type of wine with a minimal alcohol content.  If an individual is unable to tolerate mustum, there is little else the Church can do except to recommend that the person make a "spiritual communion."  Why? Because the Church believes that it is impossible to consecrate anything except wheat bread and grape wine.  From the time that the Lord Jesus took bread and wine and told his disciples "Do this in memory of me,"  the Roman Catholic Church has tried faithfully to fulfill Christ's command by taking unleavened bread made from water and wheat flour, and wine made from grapes for use at the Eucharist.

Can a priest or bishop change this teaching and consecrate a host made of rice?

No.  It is impossible to consecrate a host made of something other than wheat and water.  No priest or bishop can change this longstanding teaching of the Catholic Church.  A little over a year ago, Cardinal Joseph Ratzinger, Prefect of the Congregation for the Doctrine of the Faith, once again took up this question on behalf of the Holy Father when he wrote: "Hosts that are completely gluten-free are invalid matter for the celebration of the Eucharist."[2]

Copyright © 2004, Committee on the Liturgy, United States Conference of Catholic Bishops, All rights reserved.

[1] See Ann Whelan's "Make Your Own Decision" in Gluten-Free Living (vol. 9, no 1), p. 4.  In this same issue, see also Sr. Jeanne Crowe's extensive article on the low gluten host, "Catholic Celiacs Can Now Receive Communion," pp. 3ff.

[2] Cardinal Joseph Ratzinger, circular letter to the Presidents of Conferences of Bishops, July 24, 2003 (Prot. 89/78- 174/98) in BCL Newsletter, November 2003 (Vol. XXXIX), p. 45.