When Irene Winston was diagnosed with celiac disease four years ago, she stopped receiving Communion for a time. 

“It was just one more thing I couldn’t have,” said Winston, a Burke, Va., preschool teacher and enthusiastic cook and baker. 

Then she started receiving Communion from the cup only. 

Celiac disease is a form of gluten intolerance in which ingesting gluten — a combination of proteins found in wheat, barley, rye and some other grains — damages the small intestine and causes problems ranging from diarrhea to malnutrition. Because Communion hosts must be made of wheat flour and water, they contain gluten, making it impossible for people living with celiac to partake of the host at Mass. 

But as Winston learned more about her condition, her sister suggested she talk to a friend of hers in Chicago who also has the disease. He told her about the availability of very low gluten hosts, which have been approved for use by the Vatican and recommended by the U.S. Conference of Catholic Bishops’ Secretariat for the Liturgy, and suggested she contact her parish, Church of the Nativity, about the possibility of using them. 

“When I went to the parish office to ask about it, they told me I wasn’t the only one,” she said, and they explained the logistics of getting a very low gluten host to her, without having it come in contact with regular hosts. 

Winston, who is also an extraordinary minister of holy Communion, puts a low-gluten host in its own pyx at the beginning of Mass, and puts it in the sanctuary. It is on the altar with the other hosts when they are consecrated, and she approaches the sanctuary with the other extraordinary ministers — whether or not she is scheduled to help with Communion — and receives it there. 

“If I am scheduled for Communion, no one would ever know,” she said. “If not, they might notice me going up for Communion and then coming back.”

Increasing sales 

The hosts she uses were developed in the early 2000s and have been offered by the Benedictine Sisters of Perpetual Adoration of Clyde, Mo., since January 2004, said Sister Sophia Becker, who works in the sisters’ altar bread department. While they have some gluten, it is less than .01 percent, a level that many celiac sufferers can tolerate. 

“We had been working on it since the 1970s,” Sister Sophia told Our Sunday Visitor. “We kept getting calls from people asking if we could make anything with lower gluten.” 

The difficulty was walking the fine line between having low enough levels of gluten so that the hosts could be tolerated by people with celiac disease and having enough gluten for them to “confect as bread” as required by the Code of Canon Law, she said. 

The low-gluten hosts do not work for everyone, she said. Some people cannot tolerate any gluten at all and make a spiritual Communion. 

“The individual really has to work with their doctor,” she said, to decide whether to use the low-gluten hosts. 

The number of low-gluten hosts sold has gone up every year, and there are now 6,000 parishes and individuals who purchase them. 

Since a 2003 study estimated that about one in 133 people in America have celiac disease, with the disease more prevalent among women and among people of European descent, it’s a good bet that most congregations of 300 or more people have at least one or two people with the disease. 

However, it often goes undiagnosed, especially in cases that are less severe and don’t arise until adulthood. 

Pastoral sensitivity 

The most emotional cases seem to be those involving children who have a severe form of the disease and are approaching their first Communions. 

One such case brought celiac disease and the difficulty it causes with Communion into the public eye. At the time, a child in Boston was planning to make his first holy Communion, and his parents wanted to substitute a rice wafer for the host made of wheat. 

Bishop Christopher Coyne, now the auxiliary bishop of Indianapolis, was then serving as the director of the Office of Worship for the Archdiocese of Boston. He recently wrote about what happened in his blog, Let Us Walk Together: Thoughts of a Catholic Bishop

“When their pastor said he couldn’t use rice hosts because it wasn’t allowed, the family went to the media with their story. It ended up on the front page of the local tabloid and then was picked up by the local radio and television,” he wrote. 

When he was asked to respond, he said, “I began to return calls to the media and explain what the Church’s teaching was on this matter — that the host had to be wheat and couldn’t be anything else and that the child would just have to receive from the cup. I explained that we Catholics believe that the fullness of the Eucharistic presence is found in both the host and the chalice and that while it was unfortunate that the child could not receive the host, he could surely receive from the chalice.” 

It seemed simple, Bishop Coyne wrote, but it wasn’t, because of the emphasis the Church put on receiving the host when preparing children for Communion. At that particular parish, none of the other children received from the cup at first Communion, and the cup was not generally offered to the congregation. 

Looking back, the bishop wrote, greater pastoral sensitivity could have made all the difference. 

“The problem was that I really didn’t stop and consider that we were dealing with a family and a little boy, not a theological case study,” he said. “My whole attitude was wrong-headed. It wasn’t what I said, it was how I said it.” 

In a telephone interview, Bishop Coyne told Our Sunday Visitor that incident helped him understand that the Church must respond to people who are suffering with care and concern before turning to theology or doctrine. The issue has become more prevalent over the past several years, and affects not only people with celiac disease but also those who cannot consume wheat products for other reasons, such as having an allergy to wheat. 

That doesn’t mean the doctrine can be compromised, he said, but it has to be explained with sensitivity. 

The requirement that hosts be made of wheat is “theologically, ecclesiologically and historically based,” Bishop Coyne said. Having a consistent requirement makes Communion more or less the same everywhere in the world, an important consideration in the worldwide Church. 

Receiving from the cup 

In areas where very low gluten hosts are not available, or for people with conditions not helped by the low-gluten hosts, Communion from the cup is available. Catholics who receive either the host or the cup are considered to have had full Communion. 

What’s more, the U.S. Conference of Catholic Bishops makes clear that the faithful have the right “under the law (Code of Canon Law, Canon 843) to receive holy Communion, even if only the Precious Blood, and regardless of whether the Precious Blood is offered to the rest of the faithful present at a given celebration of Mass,” according to the USCCB website.  

Those faithful who cannot consume wheat should take care not to drink from the cup to which a bit of the host has been added. 

That’s what Winston sometimes does when she attends Mass in other parishes, she told OSV. 

“If there’s time before Mass I’ll approach the priest and tell him that I will receive from the cup only,” she said. “No one has ever had a problem with it.” 

What if you can’t have wheat or wine? 

For Catholics who cannot consume wheat products or small amounts wine — whether because of alcoholism or other conditions — parishes may provide mustum, grape juice in which fermentation has begun but has been suspended with the result that its alcohol content does not reach the levels found in most table wines. No pasteurized wine or grape juice may be used. 

Michelle Martin writes from Illinois.

On the Web (sidebar)

To learn more about what the USCCB Committee on Divine Liturgy says about holy Communion and celiac disease, visit www.usccb.org/liturgy/celiasprue.shtml

Contact information (sidebar)  

To learn more about the low-gluten Communion hosts made by the Benedictine Sisters of Perpetual Adoration, visit altarbreadsbspa.com/lowgluten.php.  

The sisters can also be reached at the following address: 

Congregation of Benedictine Sisters of Perpetual Adoration, Altar Breads Department, 31970 State Highway P, Clyde, MO 64432.  

The sisters can also be reached at 1-800-223-2772.