Celiac Disease and Communion

Monday, September 25 2006


In 1998-1999, the National Liturgy Office of the Canadian Conference of Catholic Bishops circulated a questionnaire to bishops and priests concerning the number of parishioners who have celiac disease. The priests were asked to distribute the questionnaire to people in their parish who are affected by the disease. One hundred and five responses were received. The questionnaire was also circulated in a newsletter published by the Canadian Celiac Association and, as a result, an additional fifty-five responses were received from individuals who saw the questionnaire in the newsletter.

One unanswered question is whether all parish priests are aware that some members of their parish have celiac disease. One priest commented that he was not aware that there was anyone in the parish who had this disease until he received the questionnaire and began to inquire among the parishioners. Many of these people have suffered for years in silence.

Although statistics are not readily available, it is estimated that one in every two thousand persons in Canada has celiac disease.


The purpose of this article is to present some of the facts concerning celiac disease and to look at the ways in which our parishes can help parishioners who have it to participate fully in our eucharistic liturgies. Although this is not a medical report, some medical information is necessary if our entire Church community is to deal compassionately with these individuals in helping them to cope with their medical condition and still participate in the fullest way at our celebration of eucharist. “The Church earnestly desires that all the faithful be led to that full, conscious, and active participation in liturgical celebrations called for by the very nature of the liturgy.” (Constitution on the Sacred Liturgy, no. 14)

What is celiac disease?

Celiac disease is essentially an intolerance to gluten. Gluten is a protein found in wheat, rye, barley and oats. Although gluten sensitivity is not a food allergy, individuals with celiac disease avoid foods containing wheat, rye, barley and oats in the same way those with food allergies avoid the foods to which they are allergic. For persons with celiac disease, the toxic part of the gluten molecule is the prolamin portion: gliadin in wheat, secalin in rye, horedin in barley and evedin in oats. The gluten found in corn and rice does not contain this toxic portion.

Food is digested and absorbed in the small intestine. The small intestine is lined with microscopic finger-like projections called villi designed to provide the maximum area for nutrient absorption. These villi contain digestive enzymes.

In individuals with celiac disease, gluten ingestion results in damage to and destruction of the villi. This damage can be compared to the image of shag carpet changing into linoleum. Individuals who have this disease, consequently, cannot get any kind of nutritional benefit from any food until their damaged villi are healed.

The only way to get the damaged villi healthy and able to absorb goodness from other foods again is to completely eliminate gluten from the diet. Basically, gluten is a glue that keeps much of our food together. It is found in wheat, oats, rye, barley, wheat starch, hydrolyzed vegetable protein, hydrolyzed plant protein, and some spices. A person with celiac disease cannot ingest anything with gluten in it. All food, medications and even toothpaste must be gluten-free. A failure to follow this rule will cause damage to the villi, immense pain, and, if a great amount of gluten is taken, a comatose state and even death. Consuming even small amounts of gluten can eventually lead to cancer of the bowel.


For members of our Church (this is not just a Roman Catholic issue, but crosses ecumenical lines) the difficulty lies in what makes up our communion hosts or eucharistic bread. The problem is more complicated in the Roman Catholic Church because Canon Law requires the use of “wheat flour” for hosts and eucharistic bread and as a result people with celiac disease are unable to receive communion. Other denominations are not bound by Canon Law but most use wheat flour for their communion wafers.

Recent Ecclesial Legislation

The latest guidelines coming from the Holy See on this issue is a letter dated July 24, 2003 from the Congregation for the Doctrine of the Faith to the presidents of the episcopal conferences regarding a change in the norms regarding the use of mustum and low-gluten hosts.  It reads:


Congregation for the Doctrine of the Faith

July 24, 2003

Prot. N. 89/78 – 17498

Your Excellency

The Congregation for the Doctrine of the Faith has been for many years studying how to resolve the difficulties that some of the faithful encounter in receiving Holy Communion when for various serious reasons they are unable to consume normal bread or wine.

A number of documents on this question have been issued in the past in the interest of offering Pastors uniform and sure direction (Congregation for the Doctrine of the Faith, Rescriptum, 15 December 1980, in Leges Ecclesiae, 6/4819, 8095–8096; De celebrantis communione, 29 October 1982, in AAS 74, 1982, 1298–1299; Lettera ai Presidenti delle Conferenze Episcopali, 19 June 1995, in Notitiae 31, 1995: 608–610).

In light of the experience of recent years, it has been deemed necessary at this time to return to the topic, taking up the above-mentioned documents and clarifying them wherever necessary.

A. The Use of Gluten-free Hosts and Mustum

1.     Hosts that are completely gluten-free are invalid matter for the celebration of the Eucharist.

2.     Low-gluten hosts (partially gluten-free) are valid matter, provided they contain a sufficient amount of gluten to obtain the confection of bread without the addition of foreign materials and without the use of procedures that would alter the nature of bread.

3.     Mustum, which is grape juice that is either fresh or preserved by methods that suspend its fermentation without altering its nature (for example, freezing, is valid matter for the celebration of the Eucharist).

B. Communion under One Species or with a Minimal Amount of Wine

1.     A layperson affected by celiac disease, who is not able to receive Communion under the species of bread, including low-gluten hosts, may receive Communion under the species of wine only.

2.     A priest unable to receive Communion under the species of bread, including low-gluten hosts, when taking part in a concelebration, may, with the permission of the Ordinary, receive Communion under the species of wine only.

3.     A priest unable to ingest even a minimal amount of wine, who finds himself in a situation where it is difficult to obtain or store mustum, when taking part in a concelebration, may, with the permission of the Ordinary, receive Communion under the species of bread only.

4.     If a priest is able to take wine, but only a very small amount, when he is the sole celebrant, the remaining species of wine may be consumed by a layperson participating in that celebration of the Eucharist.

C. Common Norms

1.     The Ordinary is competent to give permission for an individual priest or layperson to use low-gluten hosts or mustum for the celebration of the Eucharist. Permission can be granted habitually, for as long as the situation continues which occasioned the granting of permission.

2.     When the principal celebrant at a concelebration has permission to use mustum, a chalice of normal wine is to be prepared for the concelebrants. In like manner, when he has permission to use low-gluten hosts, normal hosts are to be provided for the concelebrants.

3.     A priest unable to receive communion under the species of bread, including low-gluten hosts, may not celebrate the Eucharist individually, nor may he preside at a concelebration.

4.     Given the centrality of the Eucharist in the life of a priest, one must proceed with great caution before admitting to Holy Orders those candidates unable to ingest gluten or alcohol without serious harm.

5.     Attention should be paid to medical advances in the area of celiac disease and alcoholism and encouragement given to the production of hosts with a minimal amount of gluten and of unaltered mustum.

6.     The Congregation for the Doctrine of the Faith enjoys competence over the doctrinal aspects of this question, while disciplinary matters are the competence of the Congregation for Divine Worship and the Discipline of the Sacraments.

7.     Concerned Episcopal Conferences shall report to the Congregation for Divine Worship and the Discipline of the Sacraments at the time of their ad limina visit regarding the application of these norms as well as any new developments in this area.

Asking you kindly to communicate the contents of this letter to the members of your Episcopal Conference, with fraternal regards and prayerful best wishes, I am

Sincerely yours in Christ,

Joseph Ratzinger


Suggested Bulletin Notice

This notice (below) could perhaps be printed once or twice a year so that new parishioners will notice it.

Communion for All

Is your participation in communion limited due to an inability to take gluten or alcohol?

We now have access to approved low-gluten hosts (approx. 0.01% total gluten content) and “mustum” (a wine substitute with less than 1.0% alcohol) that might enable you to partake more fully in the communion rite. Please contact the pastor for more details.


The National Liturgy Office is attempting to compile a list of sources, especially sources within Canada, of mustum and low-gluten hosts that meet the norms. If you can help us to add to the list below, please submit complete contact information (and the approximate gluten content of hosts in terms of percentage) to: National Office of Liturgy, 2500 Don Reid Dr., Ottawa, ON, K1H 2J2 or Fax: 613-241-8117 or E-mail: liturgy@cccb.ca.

Low-Gluten Hosts

Sisters of the Precious Blood
Altar Bread Department (Hamilton)
P.O. Box 1046, LCD 1
Hamilton, Ontario  L8N 3R4
Toll-Free: (866) 955-5727
Phone: (905) 527-9851
Fax: (905) 527-2888
Email: altarbread@pbsisters.com
Website: www.pbsisters.on.ca/altarbreads/

Congregation of Benedictine Sisters of Perpetual Adoration
Altar Bread Department
31970 State Highway P
Clyde, MO  64432
Phone: 1-800-223-2772 (toll-free)
Sr. Lynn

The Bellarmine Society
P.O. Box 7070
Oakville, Ontario  L6J 0B6
Phone: 1-800-505-3174
Fax: 1-800-735-7133
Email: admin@rbellarmine.com


Ranelle Trading/Ojai Fresh Juice Corporation
2501 Oak Hill Circle, Suite 2032
Ft. Worth, TX 76109
Phone: 1-877-211-7690 (toll-free)

Mont La Salle Altar Wine Company
385-A La Fata St.
St. Helena, CA 94575
Phone: 1-800-447-8466 (toll-free)

Low-Gluten Hosts and Mustum

DiCarlo Religious Supply Centre Inc.
TORONTO Head Office/Retail Location
14 Racine Road
Toronto, Ontario  M9W 2Z3
Phone: 416-744-7404
Phone: 1-800-208-9452 (toll-free)

HAMILTON Retail Location
1070 Main St W.
Hamilton, Ontario  L8S 1A2
Phone: 905-549-2227

For more information on Celiac Disease please refer to the Health Canada website at http://www.hc-sc.gc.ca/fn-an/securit/allerg/cel-coe/index-eng.php.


Celiac Disease and Communion, in National Bulletin on Liturgy 32/159 (1999) pages 248-251;

New Guidelines for the Use of Mustum and Low-Gluten Communion Bread, in National Bulletin on Liturgy 37/177 (2003) pages 108-111.