Celiac disease, or celiac sprue, is an inherited autoimmune disease that affects over 3 million people in the United States, or 1 in every 133 people. Celiac disease is a genetic disease and often several members of the same family will have the disease. It is caused by an immune system malfunction that causes the body to attack the lining of the small intestine, when certain proteins commonly found in the cereal grains wheat, rye, and barley are ingested. There is no cure for this disease, and the only treatment is a completely gluten free diet. This means removing all food which contains gluten from the diet, including the typical wheat hosts used for Holy Communion.

The Code of Canon Law (924 §2) states: "The bread must be made of wheat alone (mere triticeus) and recently made so that there is no danger of corruption." What does this mean in a typical Catholic Parish? With the high incidence of celiac disease or other gluten intolerance, there will likely be someone in every parish who cannot take Holy Communion with typical wheat hosts. Receiving Holy Communion is an important action by all baptized Catholics.  It is the source and summit of our faith. Not participating may make a baptized member feel marginalized, and not fully a part of the parish community.

In a circular letter to Episcopal Conferences dated June 19, 1995, then Joseph Cardinal Ratzinger, Prefect of the Congregation for Divine Worship and the Discipline of the Sacraments expanded on this canon in the light of the dilemma faced by sufferers of Celiac Sprue disease:

Special hosts quibus glutinum ablatum est [in which gluten has been removed] are invalid matter for the celebration of the Eucharist; Low-gluten hosts are valid matter, provided that they contain the amount of gluten sufficient to obtain the confection of bread, that there is no addition of foreign materials, and that the procedure for making such hosts is not such as to alter the nature of the substance of the bread.

The Benedictine Sisters of Perpetual Adoration in Clyde, Missouri, have developed a Communion host that is extremely low in gluten. The host is made from gelatinized wheat starch. The Sisters report the hosts test to a level of 0.01% gluten. At that level, the lowest that could be tested, no gluten was detected. This means that there is less than 0.01% gluten in one of these hosts. The Secretariat for the Liturgy of the United States Conference of Catholic Bishops has stated that these hosts meet the requirements of the Code of Canon Law (924 §2) and may be validly used at the celebration of the Eucharist with permission of the person's pastor. The Catholic with celiac disease can now fully participate in Holy Communion with the whole parish family.

Catholic celiacs may choose to receive consecrated wine at a regular communion station if their parish offers communion under both species. There is greater risk for contamination using this option. The fraction rite may allow small, yet dangerous crumbs to be in the cup.

Have the conversation. An open discussion between the pastor and the individuals will help everyone understand the church doctrine and teaching, as well as the practical? how to' for Holy Communion. Before Mass begins, particular arrangements for receiving Holy Communion should be discussed with the celebrant and Extraordinary Ministers of Holy Communion so that all parties are comfortable with the agreed-upon procedure. Every effort should be made to include the Catholic with celiac disease in the reception of Holy Communion. They will feel less set apart or awkward, and priests will have an increased sensitivity to their parishioners who face this challenging disease. As the opportunity arises, work together to train lay ministers, and organize the procedures for the Eucharist.

If the parishioner chooses to receive the consecrated wine at a regular communion station, contamination risk remains, but it has the benefit of allowing the Catholic with celiac disease to receive Holy Communion with the rest of the community without feeling isolated or singled out for special treatment. When using this option, it makes good sense for a Parishioner to be near the "front of the line" when receiving communion to minimize the risk of crosscontamination. Catholic celiacs should never receive from the priest's chalice in which a tiny piece of the regular wheat host is added during the fraction rite.

Because of the sensitive nature of Catholics with celiac disease it is important that the low gluten hosts are stored, consecrated and distributed completely separate from typical wheat hosts.

Low gluten hosts have an extremely short shelf-life and become stale very quickly.Store low gluten hosts in the freezer to maintain freshness.Maintain a pyx exclusively for the use of the low gluten hosts. It can easily be stored with the low gluten hosts.Do not cross contaminate the pyx with regular wheat hosts, when storing or during Mass.A consecrated low gluten host may be reserved in a pyx in the tabernacle for later use when taken to someone who is ill.

Consecrate only as many low gluten hosts as are needed at a single Eucharistic celebration.Do not place the pyx in the ciborium or on a paten containing other typical wheat hosts.  Even with the pyx closed, contamination may be enough to make someone ill.

Only break the host over the chalice for the priest and/or deaconBreaking the host over all the cups will prevent the Catholic with celiac disease from receiving the Blood of Christ.Designate one point of distribution for a cup which does not contain any particles of wheat.

Determine when the communicant will come for communion. Options include:

A specific Extraordinary Minister of Holy Communion may distribute separately to the parishioner during the regular communion time. The parishioner may come first or last to the priest or deacon, who retrieves the pyx and gives the Body of Christ.

Place a notice in the bulletin that low gluten hosts are available, and to see the priest before Mass.Include the storage and distribution of low gluten hosts in the training for Extraordinary Ministers of Holy Communion.Order low gluten hosts on a regular schedule, and dispose of stale unconsecrated hosts.Include the subject in a homily about the Body of Christ, meeting community needs, etc.

The Benedictine Sisters of Perpetual Adoration in Clyde, Missouri, have developed a low gluten host. This product is the only true, low-gluten altar bread known to the Secretariat and approved for use at Mass in the United States.

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
Sr. Rita, OSB, Manager

Website: http://www.benedictinesisters.org/

In addition to Catholic Church sources, The Diocese of Salt Lake City acknowledges the Catholic Celiac Society for this information.