Holy Communion for Catholics Suffering from Celiac Sprue Disease, Alcoholism, or Other Related Diseases

Issue: How does the Church provide for Catholics who suffer from Celiac Sprue disease, alcoholism, or other related diseases, so that they can receive Holy Communion? What are the norms that regulate the use of these alternatives?

Response: The Church recognizes some priests, deacons, and faithful are unable to consume consecrated wheat hosts or consecrated wine at Mass due to gluten or alcohol intolerance.

Communicants may always receive under one species alone—either bread or wine—and still receive the Body, Blood, soul, and divinity of our Lord. Thus, a person who is gluten intolerant may receive only from the cup, and a person who is alcohol intolerant may receive only the host, and both will receive Christ.

Additionally, low-gluten hosts and mustum (wine with a very low alcohol content) are now available as alternatives for the faithful who suffer from gluten or alcohol intolerance. A 2003 letter to the Bishops’ Conferences from the Vatican provides the current norms for regulating the use of these alternatives.

Discussion: Some priests, deacons, and faithful suffer from Celiac Sprue disease, in which a person cannot consume gluten (one of the constituents of wheat flour). Others suffer from alcoholism or other forms of alcohol intolerance. As a result, these persons are unable to consume consecrated wheat hosts or consecrated wine at Mass. The Church recognizes the challenges these diseases present, and she desires to provide for those who suffer from such diseases.

Because the entire Body, Blood, soul and divinity of Christ is present in each species individually, a person may receive only the host or only from the cup and still fully receive Christ.

The Church seeks other acceptable alternatives as well. The possibilities are bound by certain limits. In the case of Holy Communion, the only valid matter is wheat bread and natural grape wine. The Code of Canon Law specifies, "The bread must be made of wheat alone and recently made so that there is no danger of corruption. The wine must be natural wine of the grape and not corrupt."1  In this, the Church follows the example of Christ (cf. General Instruction on the Roman Missal (GIRM), no. 319), and any provision made for persons in special circumstances must conform to Christ’s example. That is to say, there are limits as to what the Church can do, because Christ Himself set certain limits and we follow the example of Christ. If the Church were to move outside these limits, she would no longer be truly providing for Christ’s people (Thus, the Church cannot allow "alternatives" made from invalid matter, such as rice hosts and grape juice).

In recent years, the use of low-gluten hosts and mustum has become an option for those suffering from gluten or alcohol intolerance. Both low-gluten hosts and mustum possess valid matter. Low-gluten hosts are hosts that have a sufficient amount of gluten to obtain the confection of the bread and are free from any other additions or substituted ingredients. They must be prepared in a manner that does not alter the nature of the bread’s substance. Mustum is grape juice that has a very low alcohol content (less than 1.0%). It is either fresh or preserved by methods that suspend its fermentation without altering its nature (for example, freezing). As with the low-gluten hosts, it must not contain any additives. (See Vatican Protocol No. 98/78-17498 and the Nov. 2003 BCL Newsletter.) Through these alternatives, the Church seeks to aid the faithful in participating in the life of the Church.

In June of 1995, the Congregation for the Doctrine of the Faith (CDF) set forth initial norms allowing the use of low-gluten altar breads for those suffering from Celiac Sprue disease or other forms of gluten intolerance. It also revised procedures for priests who suffer from alcoholism or other problems that preclude the ingestion of alcohol. Cardinal Joseph Ratzinger, then prefect of the CDF, wrote a letter to all episcopal conference presidents communicating these norms (Vatican Protocol No. 89/78).

In July of 2003, the CDF set forth new norms for the use of low-gluten hosts and mustum. Accordingly, the presidents of all episcopal conferences received a second letter from Cardinal Ratzinger (Vatican Protocol No. 98/78-17498). The 2003 norms are designed to make these alternatives more easily available to the faithful.

The 1995 norms gave the local ordinary (generally the diocesan bishop or vicar general) authority to grant permission for priests, deacons, or laypersons to use low-gluten hosts. The local ordinary was also given authority to grant priests permission to use mustum. However, authority to grant permission for laypersons to use mustum was reserved to the Holy See.

Under the 2003 norms, the local ordinary has authority to grant permission for priests, deacons, or laypersons to receive Communion under the matter of mustum as well as low-gluten hosts. Additionally, medical certification of a condition justifying the use of low-gluten hosts or mustum is no longer required. Cardinal Ratzinger also reminded the episcopal conference presidents that a layperson who is not able to receive Communion under the species of bread may receive Communion under the species of wine only.

Given these norms, a person who is gluten or alcohol intolerant should be able to make arrangements with his pastor to have low-gluten hosts or mustum present. The use of these alternatives is reserved to those who need them. For example, if a person can only receive Communion under the matter of mustum, the priest will consecrate a separate chalice for that person along with the customary bread and wine for the rest of the congregation.

Because celebrating Mass is central to the priesthood, the 1995 norms added that men who are affected by Celiac Sprue disease or suffer from alcoholism or similar conditions may not be admitted to the priesthood. In his 2003 letter, Cardinal Ratzinger noted a modification to that norm, saying "Given the centrality of the celebration 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." The Cardinal’s 2003 letter also provides norms for the celebration and concelebration of Mass when the celebrant or concelebrant suffers from gluten or alcohol intolerance.

[1] Canon 924.2-3. See also Code of Canons of the Eastern Churches, Washington, DC, 1992, canon 706.

For Further Reading
USCCB, Nov. 2003 BCL Newsletter (includes Vatican Protocol No. 98/78-17498. Available online at www.usccb.org/liturgy/innews/1103.shtml)
USCCB, "A Short Introduction to Holy Communion and Celiac Sprue Disease" (Available online at www.usccb.org/liturgy/celiasprue.shtml)

Recommended Reading
Holy Bible (Catholic edition)
Catechism of the Catholic Church
Documents of Vatican II
Sacrosanctum Concilium
Cardinal Ratzinger, Spirit of the Liturgy

To order, call Benedictus Books toll-free: (888) 316-2640. CUF members receive a 10% discount.

Father Thomas Acklin, O.S.B., The Unchanging Heart of the Priesthood
Michael J. Aquilina and Kenneth Ogorek, eds., The Great Life: Essays on Doctrine and Holiness, in Honor of Fr. Ronald Lawler, O.F.M. Cap.
Michael Barber, Coming Soon: Unlocking the Book of Revelation and Applying Its Lessons Today
Hahn and Suprenant, eds., Catholic for a Reason: Scripture and the Mystery of the Family of God
Leon Suprenant and Philip Gray, Faith Facts: Answers to Catholic Questions
Leon Suprenant, ed., Servants of the Gospel
Most Rev. Thomas J. Tobin, Without a Doubt: Bringing Faith to Life

To order these and other titles, call Emmaus Road toll-free: (800) 398-5470.

Available Faith Facts
Bread and Wine Used in Consecration of Eucharist
Defending Our Rites: Constructively Dealing with Liturgical Abuse
Following Our Bishops
Holy Communion under Both Species
Signs of Christ: Sacraments of the Church
Smells, Bells, and Other Liturgical Odds and Ends

© 2006 Catholics United for the Faith
Last edited: 3/06

Date created: 3/14/2006
Date edited: 5/13/2009