USCCB: “Celiac Disease, Alcohol Intolerance, and the Church’s Pastoral Response” (Gluten, mustum, etc.)

From the Newsletter of the USCCB’s Liturgy Committee for October:

Celiac Disease, Alcohol Intolerance, and the Church’s Pastoral Response

Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley, and rye. For those with the disease, eating gluten triggers an immune response in the small intestine. Over time, this immune reaction damages the small intestine’s lining and hinders absorption of some nutrients. The intestinal damage often causes stomach pain, diarrhea, and weight loss, and can lead to serious complications. A Mayo Clinic-led analysis published in 2012 estimates that roughly 1.8 million Americans have the disease, but around 1.4 million of them are unaware that they have it.
Given the serious health risk for those suffering gluten intolerance, it is important for pastors and other Church leaders not only to be aware of the reality, but prepared to address the situation of Catholics with celiac disease who come to parishes and seek to receive Holy Communion in a safe, sensitive, and compassionate manner.

The Risk of “Cross-Contamination”

For those members of the faithful with gluten intolerance, even trace amounts of gluten can be damaging. It is important, therefore, to be mindful of “cross-contamination” when using either low-gluten hosts or when offering Holy Communion to someone only under the species of wine. It might be best, for example, for the communicant to prepare a pyx with the low-gluten host before Mass, in order to avoid the situation of a sacristan who has handled the other hosts also to handle the low-gluten ones. At Communion time, then, they could approach the sanctuary together with any Extraordinary Ministers of Holy Communion and receive the pyx from the celebrant with the words “The Body of Christ” (or, if possible, they could be given the pyx within the normal Communion line, provided “contamination” from handling of the pyx is avoided). Similarly, it might be necessary for someone who has permission to receive Holy Communion under the species of wine alone to prepare before Mass a chalice, which will not be part of the commingling rite and from which either they alone will receive or from which they will be the first to receive. Such precautions are not only medically necessary, but they demonstrate compassion to avoid singling out those who want to receive Communion, but are unable to receive one or the other species.

Low-Gluten Hosts and Mustum

The most recent Church teaching on the use of mustum and low-gluten hosts at Mass remains the letter from then-Cardinal Joseph Ratzinger on July 24, 2003 (Prot. n. 89/78-17498), which was addressed to the Presidents of Conferences of Bishops: HERE.

In that letter, pastors and the faithful are reminded that for bread to be valid matter for the Eucharist, it must be made solely of wheat, contain enough gluten to effect the confection of bread, be free of foreign materials, and unaffected by any preparation or baking methods which would alter its nature. The amount of gluten necessary for validity in such bread is not determined by minimum percentage or weight, though hosts which have no gluten are considered invalid matter for Mass. (In the Roman Rite, the bread prepared for the Eucharist must also be unleavened.)

Mustum is defined as grape juice in which fermentation has begun, but has been suspended with the result that its alcohol content (usually less than 1.0%) does not reach the levels found in most table wines. It should not contain additives and may be stored through freezing or other means. The process used for the suspension of fermentation must not alter the nature of the juice in any way. The amount of alcohol needed for validity in mustum is not determined by a minimum percentage or weight. Pasteurized grape juice in which all alcohol has been evaporated through high temperature preparations is invalid matter for Mass. In the United States, it is forbidden to sell wine without the addition of sulfates as preservatives. The Church has determined that the very small amount of sulfates is acceptable and does not make the matter invalid.

The lay faithful who are not able to receive Holy Communion at all under the species of bread, even of low-gluten hosts, may receive Holy Communion under the species of wine only, regardless of whether the Precious Blood is offered to the rest of the faithful present at a given celebration of Mass.

Permission for priests, deacons, or the lay faithful without distinction to use mustum or low-gluten hosts is within the competence of the diocesan Bishop. The authority to permit the lay faithful to use mustum and low-gluten hosts in the reception of Holy Communion may be delegated to pastors under canon 137 §1 of the Code of Canon Law. Medical certification of a condition justifying the use of mustum or low-gluten hosts for Holy Communion is not required. Such permission, once granted, stands for as long as the condition persists which occasioned the request for the original permission.

As a best practice, it is recommended that individuals with gluten and/or alcohol intolerance arrange through their parish the purchase any low-gluten hosts or mustum. This facilitates the oversight and good stewardship of the pastor who is responsible as mentioned above. It also “normalizes” the practice for the communicant, as well as keeping the purchase of liturgical supplies together in the parish budget.
It is also worth recalling that, through the doctrine of concomitance, the Church teaches that under either species of bread or wine, the whole Christ is received (cf. General Instruction of the Roman Missal, no. 282; Catechism of the Catholic Church, no. 1390). Thus, the faithful may be confident in the Real Presence of Christ in the Eucharist they receive, even under only one or the other species.

Obtaining Low-Gluten Hosts and Mustum

In the dioceses of the United States, there are three approved distributors of low-gluten hosts and two of mustum known to the Secretariat of Divine Worship. (Any additional low-gluten host and/or mustum distributors are strongly encouraged to contact the Secretariat so that an up-to-date listing may be maintained.)

Low-Gluten Hosts
Benedictine Sisters of Perpetual Adoration
Altar Breads Department
31970 State Highway P
Clyde, MO 64432-8100
Phone: (800) 223-2772
E-Mail: altarbreads@benedictinesisters.org
Web: www.BenedictineSisters.org
Gluten Content: 0.01%

Parish Crossroads P.O. Box 84 Zionsville, IN 46077-0084 Phone: (800) 510-8842 E-Mail: admin@parishcrossroads.com
Web: www.ParishCrossroads.com
Gluten Content: 0.016%

GlutenFreeHosts.com Inc.
100 Buckley Road
Liverpool, NY 13088
Phone: (800) 668-7324 ext. 1
E-Mail: info@glutenfreehosts.com
Web: www.GlutenFreeHosts.com
Gluten Content: 0.002%

Mustum

Mont La Salle Altar Wines
605 Trancas Street, Suite D
Napa, CA 94558
Phone: (800) 447-8466
E-Mail: info@montlasallealtarwines.com
Web: www.MontLaSalleAltarWines.com

Monks Wine & Candles
P.O. Box 681248 Schaumburg, IL 60168 Phone: (800) 540-MONK (6665) E-Mail: info@monkswineandcandles.com
Web: www.MonksWineAndCandles.com

Conclusion

“Any baptized person not prohibited by law can and must be admitted to Holy Communion” (can. 912). It is important for pastors to make every effort to accommodate and normalize the experience of Communion for the faithful, including those suffering from celiac disease. As this article points out, such can certainly be done within the norms of Church teaching.

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Fr. Z is the guy who runs this blog. o{]:¬)
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63 Responses to USCCB: “Celiac Disease, Alcohol Intolerance, and the Church’s Pastoral Response” (Gluten, mustum, etc.)

  1. Suburbanbanshee says:

    So the bishops _can_ offer clear, explicit regulations.

    Re: folks with gluten problems arranging to have the parish buy supplies, of course it would be charitable for parish groups to make sure the parish has some extra budget money for this need.

  2. acardnal says:

    It’s interesting that the USCCB instruction states that ” hosts which have no gluten are considered invalid matter for Mass”and yet they list a purveyor of hosts named “GlutenFreeHosts.com Inc.”

  3. mamajen says:

    One of those companies is very close to home. Neat!

    In my parish the priest has a tiny little ciborium that he has dedicated for the low-gluten hosts. The people requiring them come up for communion last. He does distribute to them after handling all of the regular hosts, so I have wondered about the cross-contamination, but apparently the people who receive are okay with the arrangement.

  4. dominic1955 says:

    If you actually go to the site, they clearly list that they have a Catholic compliant version that has a minimal amount of gluten approved by the Church and then one that is made from potatoes (for Protestants I’d assume). “Gluten Free” isn’t meant in the absolute.

  5. Father P says:

    glutenfreehosts.com has two products. One what they call “gluten free” is actually wheat with very low gluten and has received the OK of the UK Bishops. The other is “zero gluten” and is potato and, to credit the company, is made very clear that this would not comply with the norms of the Catholic Church.

  6. acardnal says:

    Thanks for that clarification, Father P. Good info.

  7. Amerikaner says:

    Is this promulgated to the priests in a diocese by their bishop or does the responsibility fall on the individual priest to learn about this and the bishop’s statement? I am just wondering how priests will be informed.

  8. In the United States, it is forbidden to sell wine without the addition of sulfates as preservatives.

    What gives them that idea? Most wine contains added sulfites (not “sulfates”) and wine with more than 10PPM in sulfites is required to bear a label statement in the U.S. (because some people are allergic to sulfites).

    The United States Department of Agriculture has a program for labeling organic wine, which “cannot use added sulfites in production” and if it is tested to have less than 10 PPM of sulfites need not bear the “contains sulfites” labeling.

  9. thereseb says:

    “Pasteurized grape juice in which all alcohol has been evaporated through high temperature preparations is invalid matter for Mass”

    This is interesting. The makers of Fre and Carl Jung wines use different methods to extract alcohol from their wine. They also add a rider that 100% of the alcohol cannot be removed, so their wine “contains less than 0.5 percent alcohol”. In practice I believe this is less than that present in a ripe banana, but the trace is there. The number of those with both a gluten and an alcohol allergy/alcoholism who would have to receive mustum only, would, I suspect, be miniscule. However, there are a proportion of excellent priests who develop alcoholism, and as wine technology is developing all the time, I would have thought that it might be useful to work with the wine companies to produce an acceptable wine in line with Catholic requirements.

  10. Speravi says:

    So are they saying that if I have touched a normal host and then touch the low-glutten host, I am transferring more glutten to the low-glutten host than it already has in it? I do know some people with serious celiac who can only take Precious Blood. However many others take the low gluten hosts and they have never seemed worried about cross contamination. I have always avoided getting the low gluttens mixed with the regular hosts, but it surprises me to see the suggestion that a priest who has touched the large host of the Mass not even be allowed to touch the low-glutten host at all.

    Additionally, what is the deal with the mustum? I thought that was only for use by priests who are recovering alcoholics… Why would the laity ever need it? They don’t need to receive both species. I guess it might be a solution for alcoholics with Celiac disease.

  11. The Masked Chicken says:

    “In the United States, it is forbidden to sell wine without the addition of sulfates as preservatives.”

    Not to be pedantic, but it is sulfites, SO3, not sulfates, SO4, that are used as preservatives, most commonly, sodium sulfite, sodium bisulfite, sodium metabisulfite, potassium bisulfite and potassium metabisulfite. Sulfites naturally occur in the fermentation process (they ARE derived from sulfate salts that occur in the soil) and can be even used to stop fermentation by using them as a “limiting reagent.”. Sulfur dioxide, SO2 is produced by the yeast and this reacts with water according to the two-step reaction:

    SO2 + H2O —–> H2SO3
    H2SO3 2H+ +SO3 2-

    The sad thing is that some people are allergic to sulfites. I suspect they use sulfites to limit the amount of alchohol in wines (maybe not in all wines). If such were the case and the person also had Celiac’s disease, then they would have to abstain from communion.

    The Chicken

  12. The Masked Chicken says:

    That equation didn’t print:

    SO2 + H2O —–> H2SO3
    H2SO3 2H+ +SO3 2-

  13. The Masked Chicken says:

    Last try:

    SO2 + H2O —–> H2SO3
    H2SO3 —–> 2H+ +SO3 2-

    The second step is an equilibrium, so I tried to use a two-sided arrow.

  14. APX says:

    @Speravi
    However many others take the low gluten hosts and they have never seemed worried about cross contamination.

    Some people seem to be very sensitive, or perhaps overly cautious to avoid even the possible risk. I had a roommate who would become violently ill if she accidentally consumed even the tiniest crumb.

    I also know of a priest who is so sensitive that he cannot consume low gluten hosts, thus when he offers Mass he can only receive under one species and has to leave out the commingling rite to avid cross contamination.

  15. tzard says:

    Re alcohol and water – from a purely mathematical/scientific perspective, you can never remove all the alcohol from wine. But, you can remove enough so it’s such a trace level that it’s effectively not there. Boiling would do that. The Church has made a prudent judgement that pasteurized grape juice is not valid matter – and that seems a very reasonable ruling.

  16. RuralVirologist says:

    I’m still curious as to the difference between “must” and “fresh grape juice.” Both contain alcohol. theresab pointed out that a ripe banana contains alcohol. So does normal human blood in someone who has not drunk anything alcoholic.

    CDF letter to episcopal conference presidents, 24 July 2003: “Mustum, which is grape juice that is either fresh or …” [link: http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20030724_pane-senza-glutine_en.html ]

    Summa Theologica Q74 Article 5 reply to objection 2: “It is furthermore forbidden to offer must in the chalice, as soon as it has been squeezed from the grape, since this is unbecoming owing to the impurity of the must. But in case of necessity it may be done: for it is said by the same Pope Julius, in the passage quoted in the argument: ‘If necessary, let the grape be pressed into the chalice.’ “

    So if I squeeze a few ripe grapes into a glass, is that okay for the Eucharist (in cases of necessity)? It would seem so. This seems more lenient than the USCCB letter.

    Does the packaging and preservative-adding process that makes bottled/boxed grape juice alter the nature of the liquid so that it remains grape juice with <0.5% alcohol but no longer valid matter for the Eucharist?

    USCCB: “Pasteurized grape juice in which all alcohol has been evaporated through high temperature preparations is invalid matter for Mass.”

    As theresab pointed out, one cannot get rid of “all alcohol” – so surely that statement excludes something that doesn’t exist? Pasteurisation is used to kill the organisms that might grow, and some of those would increase the alcohol content. It isn’t boiling. But pasteurisation won’t remove all of the alcohol. Adding brandy to a cake mix and heating it up to a much higher temperature for a much longer time than pasteurisation does not remove all the alcohol from the cake.

    Non comprehendo.

  17. The Masked Chicken says:

    I realize that this is not the topic of the post, but someone mentioned that totally steam-distilled wine contains less alcohol as a ripe banana. A little chemistry music, please:

    For a non-ripe banana (source: USDA):
    Alcohol, ethyl
    Amount in 100 grams of edible portion
    0.0 0 0 g

    So, no alcohol in a regular banana.

    Bananas contain sugars, which, when fermented will yield alcohol (so, yes, ripe bananas contain a trace of alcohol).
    This paper:
    http://www.aseanbiotechnology.info/Abstract/22000525.pdf

    gives the figure of ethyl alcohol for a ripe fruit part of the banana at .091 L/kg. The edible part of a single banana is about 120 g or .120 kg. so, in an average ripe banana, there would be .o191 L = 19.1 mL of alcohol.
    Now, if the 19.1 mL of alcohol is dissolved in 1 Liter of water, this would give a % v/v of 1.91% alcohol in the ripe banana.

    So, proof, that the very low alcohol (de-alcoholed) wine has less alcohol than a ripe banana. Now, you know. By the way, I hear they taste awful.

    The Chicken

  18. Titus says:

    There was a study done in the last few years that strongly suggested that flour (or perhaps unground what) could be subjected to a shockingly simple process that made it edible for celiac sufferers. I can’t for the life of me recall where the study was published . . .

  19. The Masked Chicken says:

    The de-alcoholed wines, not the bananas :)

    The Chicken

  20. The Masked Chicken says:

    Opps…epic fail.

    %v/v = Vsolute/(Vsolute +Vsolvent), so:

    19.1 mL/(1019.1 mL) x 100% = 1.87% by volume. I used an acceptable approximation in the above.

    The Chicken

  21. acardnal says:

    Chicken, are you sure you are not conversing with yourself? ;-)

  22. Clinton R. says:

    Where has this celiac disease come from? Never heard about until the last 10 years or so. I wonder if it comes from all the genetic modified food that is forced down our throats from the likes of Monsanto?

  23. wmeyer says:

    I wonder if it comes from all the genetic modified food that is forced down our throats from the likes of Monsanto?

    Or from all the food fads supported by the FDA and CDC, without any supporting data.

  24. Banjo pickin girl says:

    Celiac disease is one of those diseases that was always diagnosed as something else until someone decided to take a closer look. It has nothing to do with “GM foods.”

    There are some quack “gluten intolerance tests” which purport to give a “score” which in fact don’t measure at all what they purport to measure. Beware of quackery, especially when it is against something new or scientific. Most people are pretty scientifically illiterate. I have friends on the zero gluten diet and they lose lots of weight and I ask them what they replaced the starch calories with and I get a blank stare. They think the laws of thermodynamics don’t apply to eating, which they do.

    People with true celiac disease suffer terribly.

  25. Phil_NL says:

    To those above: negative. Coeliac disease has been known as such since the 40s/50s, long before genetical manipulation was about. Descriptions matching the disease are even older.

    The tendency to diagnose it is fairly recent, but only because it’s (was) quite hard to do so, unless it gets really severe.

  26. VexillaRegis says:

    As far as I know, the disposition often runs in the family. According to my severely celiac friend (with extremely celiac children…) there is a genetic test for this. Sadly it’s under diagnosed, even today. In the olden times some people with this terrible disease just didn’t make it into adulthood.

    The gluten proteine causes your bowels to lose the villi, which makes it hard for your body to absorb the nutrients of the food. Your digestive system just crashes, with diarrhoea and awful cramps. In cultures where “our daily (wheat) bread” is the norm, you are in serious danger, if you do not know that you have to avoid maybe even the flour dust.

    I had to rescue this dear friend a couple of times when she collapsed. She got her diagnosis at 25, and said to me: Wow! I always thought that everybody also had a constantly aching stomach.

    Please forgive me if my medical English isn’t completely accurate :-)

  27. Speravi says:

    acardnal ,
    Perhaps the Chicken is celebrating that fact that St. Albert the Great is the patron saint of scientists!

  28. Springkeeper says:

    Celiac Sprue is diagnosed with a biopsy. There are those who can consume a small amount of gluten and not have symptoms but in reality they should not eat any at all for the rest of their lives because even small amounts do damage. Some can’t tolerate any amount of gluten and cross contamination is a real concern but sadly, like any other “trendy” illness, you get the ones who just want to jump on the bus with actual sick people. I have had patients ask me if they should go gluten-free only because they heard it was “healthier”.

  29. biberin says:

    Modern wheat is pretty different from wheat even 50 years ago, and way different from what was around thousands of years ago. Breeding it to be able to make Wonder Bread (or any machine-processed baking) requires more gluten for the stretchiness of it. So while it’s genetic, I’m betting that celiac is so much more severe in many people these days, and getting diagnosed more often, because modern wheat is more insulting to the gut.

    I am very fortunate that my parish is extremely celiac friendly and both pastor and deacon go out of their way to be accommodating. All you have to do is let an usher know before Mass, and remember to get in the priest’s line, and you’re covered.

  30. VexillaRegis says:

    Another thing to consider, is that quite a lot of us have our ethnic roots in countries, where wheat was difficult to grow. Here we ate barley and oat, later even rye, and if you got wheat at all, you had a piece of wheat bread at Christmas. Only the royalty and some nobility could afford to eat wheat. It wasn’t till the late 1800′s, that farmers and workers started having “fine” bread regularily.

    So, our genetic setup isn’t very accustomed to gluten. (Barley and rye do contain gluten, but much less.) Maybe this contributes to the increasing prevalence of C D here.

  31. Peter in Canberra says:

    I wonder how this plays out in the extraordinary form wrt receiving from the Chalice?

  32. Ellen says:

    I know very few people who are truly gluten intolerant but I know a lot of people who boast “We are gluten free”. I just wonder what the next fad nutritional trend will be. At Mass, the priest gives the gluten intolerant people communion from the chalice. It works out fine.

  33. gloriainexcelsis says:

    In our small parish we have two families, plus my daughter with either gluten “sensitivity” or downright gluten “intolerance.” For the one young girl, Father has a small ciborium with a low gluten host. For the other family, with two gluten intolerant members, and my daughter, Father has a second chalice. After the congregation has received, he makes two separate trips to the altar to accomodate these communicants. So far there seems to be no problem with cross-contamination.

  34. The Masked Chicken says:

    “Perhaps the Chicken is celebrating that fact that St. Albert the Great is the patron saint of scientists!”

    I did know it was the feast of St. Albert. I have called on his help many times during lectures. I just thought it would be a little fun in the afternoon to check out the proposition that de-alcoholed wine has less alcohol than a ripe banana. Hey, it was fun for me. The difference between we nerds and you people who have a life is that if you say something cute that involves numbers, we will pull out our slide rules to prove it (yes, I have at least five slide rules, including two on my iPad).

    On the bright side, if the subject ever comes up in conversation (!), at least you’ll have the numbers.

    The Chicken

  35. This post certainly has generated much very interesting commentary, way beyond my pay grade.

    I can only comment about my parochial experience concerning this matter. And, it is reserved strictly to partaking of gluten-free hosts.

    First, the phenomenon of communicants requesting gluten-free Holy Communion is a relatively recent phenomenon, that is, within the past three years. After being requested by a parishioner to consecrate gluten-free hosts, I did some research into the subject. I did not find any evidence that consuming a host containing gluten has caused suffering or death. Perhaps doing so would; however, I have found no research evidence that this has happened. In turn, this finding has led me to wonder whether the recent increase in the number of parishioners requesting gluten-free hosts represents an excessive concern with self.

    Second, the “need” to “receive Holy Communion my way” smacks of what’s been elsewhere called “the fast-foodization” of Holy Communion. That is, the parishes are now required to serve up Holy Communion per a parishioner’s request…sort of like Burger King, where a customer can “have it your way.” If there is evidence indicating that hosts containing gluten present a health hazard, shouldn’t every parish switch entirely to gluten-free hosts, just to keep the trial lawyers at bay?

    Third, and based solely on my parochial experience, I’ve noted that those who “need” to receive gluten-free Holy Communion tend to be of substantial personal means. While my sample is too small to generalize to the population, these individuals drive high-end cars, wear high-end clothes, in all other aspects appear to be in the finest of health, and present the most beautiful pyxes containing their gluten-free hosts that I have ever seen. I mean really beautiful…one has inlaid pearl setting off an ivory cameo of the Last Supper. I don’t mean to be cynical or disparaging, but is this phenomenon akin to what the Kings and Queens of yore used to do, that is, demand part of the priest’s host for Holy Communion? (I raise this comment because a parishioner [Zeldamena Maria Theresa von Hohenzollern] lived in a parish where I served at decades back. A descendant of the Hohenzollern royal family, she demanded that her host be from the priest’s host. )

    Does this phenomenon represent a true “need” based upon a probably health risk?

    Those are my comments, for what they’re worth.

  36. RuralVirologist says:

    @Monk: Certainly, coeliac disease has become fashionable in some circles. So has “gluten-free” stuff. Perhaps this has given it a bad name because it may be associated with some who are pretentious. However, it’s a real disease, and does cause significant discomfort in those who really suffer from it – ranging from mild diarrhoea to severe, debilitating abdominal cramps, skin rashes, and a lot of other nasty things. Sufferers are also at a higher risk of developing certain cancers, and these can be prevented with diet. The damage ingested gluten causes to intestines can eventually lead to intestinal obstruction, which is often lethal without emergency surgery. It’s not like diabetes where diabetics can have a little sugar and still be okay. It’s closer in severity, for many, to an allergy to nuts or seafood or bee stings, although the mechanisms behind the disease are not the same as with allergies.

  37. I get that and thank you, RuralVirologist. I have a friend who suffers from anything that contains milk and I am allergic to nuts (but not peanuts) and bee sting, so I can personally identify with the effects.

    My question remains: Is there any evidence that the effects you identify can be caused by a host containing gluten?

  38. Tantum Ergo says:

    ” It should not contain additives.” Fr. Z, could you possibly wade in?

    This begs the question (which I’ve tried and tried to get answered) What is the validity status of common super market table wines for Mass? Canon law has explicit guidelines for wines to be used in the Mass. Commercial wines are not made with the object of canonical approval, but are often altered with sweeteners and/or other additives to maintain consistancy in color and taste from season to season. As our parish is quite large, and goes through gallons and gallons of Gallo, this may well be the 800 lb. gorilla in the sacristy.

  39. RuralVirologist says:

    Yes. Wikipedia (not always the best source for info, but it has a nice summary of this) covers it in quite a bit of detail at http://en.wikipedia.org/wiki/Coeliac_disease#Pathophysiology – rather complex for a non-medic, but enough to demonstrate that the mechanisms are quite well understood. And yes, for those who have severe symptoms, tiny amounts can have very severe consequences. Even mild sufferers can experience nausea and vomitting – NOT something you want to induce immediately after receiving the Eucharist.

    Like nuts and bee stings, this disease has a spectrum of severity. For those with mild disease, a normal Host can probably be tolerated, and they’ll suffer from flatulence for a few days, maybe a cramp or two, and then it passes. However, repeated exposure to gluten can worsen the condition, so it’s really not advised.

  40. RuralVirologist says:

    Btw, peanut allergy and nut allergy are different entities – peanuts are legumes, like peas and beans. People with peanut allergy are often allergic to peas as well. Nuts from trees are quite different things biologically, although we tend to lump them together as “nuts” because we eat them the same way.

  41. biberin says:

    “Second, the “need” to “receive Holy Communion my way” smacks of what’s been elsewhere called “the fast-foodization” of Holy Communion.”

    I am very grateful to my local clergy, because if I couldn’t receive the Eucharist “my way,” I would not be able to receive at all. And I wish you could have seen the joy from an out of town friend, whose parish does not accommodate her, when she learned she could receive Jesus at my parish and it would be No Big Deal.

    Those of us with celiac kids are constantly having to prevent people who don’t believe in the problem from slipping our kids just a little cookie or piece of cake. It is no fun at all to deal with a kid who is out of sorts for days because of gas and diarrhea. So maybe we all know “somebody” who is of substantial personal means, whom we suspect doesn’t really need a low-gluten host. Fine. But please, please, for the sake of charity (and because they may appear to be in fine health precisely because they avoid gluten), assume they really need it and accommodate them as graciously as you can.

    Oh, and nobody uses low gluten for everybody because the special hosts are significantly more expensive. And yes, I do put more in the plate to cover it, though no one has ever asked.

  42. Banjo pickin girl says:

    Motley Monk, a regular host contains sufficient gluten to make a celiac sufferer sick. And to worsen the disease by its effect on the immune system damage to the gut.

  43. The Masked Chicken says:

    Here is a paper that outlines reaction thresholds:

    http://www.celiac.org/images/stories/PDF/catassi%20study%20on%20gluten%20tolerance.pdf

    The safe limit is 50mg/day. Now, the low gluten hosts have been calculated, by Sister Jeanne Patricia Crowe, Pharm D, R Ph. of Immaculata College in Pennsylvania, to contain 32 μg of gluten. A regular host would contain (it is hard to find data) 7% gluten or 16mg. The analysis is complicated by finding the mass of a communion host (apparently there are 125 to an ounce) and percent protein in unleavened bread (Matzo has 10.6%).

    http://www.catholicceliacs.org/Options.html

    The Diocese of Columbus, Ohio says that gluten-free hosts are not valid matter because they o not continue true wheat.

    The Chicken

  44. biberin says:

    I think it’s important to note in that study that they were dealing with people who had been diagnosed and on a gluten-free diet for >or= 2 years. So those folks would be on the way to healing. I wonder what the tolerance is for people with shredded guts who only just figured out they need to be gf. In my limited experience, those are the folks who are most bothered by tiny amounts.

    I tend to figure that I never know when one of us is going to be hit with something contaminated that usually isn’t, so if we can reduce the odds with a low gluten host, it’s worth the trouble.

  45. One question, Masked Chicken:

    Even if the data are hard to find, am I reading correctly the data you report: These data suggest that low-gluten hosts have less gluten than regular hosts?

    I would also guess that “safe” is relative. What’s safe for someone who doesn’t suffer from celiac disease may be troublesome for someone who does.

    TMM

    PS: Biberin: Whoever said anything about not accommodating people who ask for gluten-free Holy Communion? All I did was to comment about my experiences.

  46. The Masked Chicken says:

    I might have confused people. The low gluten hosts and the gluten-free hosts (not really entirely gluten free) are, if I interpret the new release properly, the same thing. They are not allowed in Columbus.

    The Motley Monk,

    Yes, low gluten hosts have 1/10,000 the gluten of regular hosts. That is probably not enough to make it rise (gluten is an elastomer that expands during the fermentation process as air gets trapped in the interelastomeric matrix – like a bloated stomach), so it is questionable as to whether or not it is real wheat. As long as the Vatican accepts them, that’s good enough for me, however, but apparently, not for Columbus, Ohio (assuming low gluten and gluten-free are the same thing).

    The Chicken

  47. biberin says:

    TMM, my request to err on the side of charity was to the world in general, not just to you.

    Too often my experience is that when these things get chewed over, stories of people who are “fakers” come up, and people start wondering whom to believe, and pretty soon consensus is that it’s mostly make-believe. I found your words about people asking for low gluten hosts “my way” smacking of fast-food-ization to be pretty harsh. I think if I were in a parish where the pastor held that view, it would be apparent to me, and i would be much more hesitant to ask to be accommodated. Instead, their explicit position is that they want to do everything possible to make the Eucharist accessible to everyone—which includes Confession on short notice, too.

  48. The Masked Chicken says:

    “I think it’s important to note in that study that they were dealing with people who had been diagnosed and on a gluten-free diet for >or= 2 years. So those folks would be on the way to healing. I wonder what the tolerance is for people with shredded guts who only just figured out they need to be gf. In my limited experience, those are the folks who are most bothered by tiny amounts.”

    Yes, that is an important caveat, but it would be unethical to use a subject population of diagnosed, but untreated Celiacs, since, under medical ethics, one cannot just leave a patient go for a medical study. It would also violate moral theology. One may not do an evil that good may come from it. This study may be the best we can do. For new Celiacs, one would simply have to set the threshold lower and observe if healing can take place under those conditions. These are the limitations of working with human subjects.

    The Chicken

  49. biberin says:

    Oh, absolutely! I’m not suggesting experimenting on anyone, just anticipating the argument that since a regular host contains less than 50mg of gluten, celiacs shouldn’t need a special one.

  50. Suellen says:

    I was diagnosed Celiac 5 years ago. I started receiving only the Precious Blood. I did not feel comfortable about this. I prayed. In my “raw guts” stage of healing I couldn’t even breathe flour without getting a headache. But, I came up with a rather sentimental idea that, “Jesus wouldn’t hurt me,” and began receiving under both species again. I then went to my spiritual director and relayed that, lo and behold, I suffered no adverse effects. In his outstanding socratic method, he asked me why I thought this was. I offered my, “Because, Jesus wouldn’t hurt me” answer. “NO! That is not why! You are receiving with no ill effects because IT’S NOT WHEAT!” Only the appearance of wheat remains. It’s human tissue. Human heart tissue. Sacred Heart Tissue. I understand this takes quite a bit of faith. I understand that the Church has to be sensitive to people and their conditions. And yet, what a profound teaching moment. It’s. Not. Wheat. Better still, He’s not wheat. Five years later, I still can’t eat gluten, by am a healthy daily communicant. Praise be to God in His Sacred Heart.

  51. Peter in Canberra says:

    I find it somewhat disturbing that some posters want to argue the existence of these pathologies and demand proof of their existence.

    As to proof that a host with gluten causes a reaction, well I don’t need to test out whether a host with a proportion of arsenic or cyanide in it will predictably result in the well documented pathologies associated with those toxins. That could be described as fundamentalist empiricism.

  52. The Masked Chicken says:

    “As to proof that a host with gluten causes a reaction, well I don’t need to test out whether a host with a proportion of arsenic or cyanide in it will predictably result in the well documented pathologies associated with those toxins. That could be described as fundamentalist empiricism.”

    I’ve used that argument myself, before. It does not always apply, since there are some situations where a specific “fact” has turned out to either be wrong or depend on circumstances. For example, tomatoes were considered poisonous in England in 1600 and the belief persisted for maybe a hundred years. How facts are tested is an art. Someone had to have eaten cyanide at some point. That was not the best way to establish the fact of its nature, however :)

    The Chicken

  53. LisaP. says:

    We don’t have Celiac in the house, but I’ve had to study it a bit for outside reasons, so there’s no self-interest (much less high-end vehicles! :) ) in this comment.

    People really, really, really need to understand that true Celiac disease is *autoimmune*. What this means is that the body reacts to a substance as if it were a pathogen. The body then attacks and destroys a part of itself. It’s a misfire.

    One test for Celiac is an antibody test. It isn’t always accurate (if you eat gluten free before the test, for example, the test may not be able to detect them) but that tells you something. Antibodies are what the body creates to fight a foreign invader — like a virus. While the comparison is not one to one (for example, gluten contaminants don’t reproduce!), it’s worth thinking of it this way — no one would ever question whether “just a little bit” of a viral infection would be all right, would they? No one would ever think someone was kind of a drama queen if she worried about just a few little spores of anthrax in her lungs or a tiny amount of Ebola virus contamination? And while it’s true that a strong and healthy person may be able to actually fight off a viral infection before symptoms even occur, the fight still happens.

    So with a Celiac exposure, if you get exposed to gluten your body reacts. The fight is on. Individuals with Celiac may not feel the damage being done, or may for their own reasons (lifestyle, spiritual decisions, whatever) decide to endure the damage. But no one from the outside should feel free to suggest a person with Celiac disease should just take a hit.

    If Celiac did its damage on the outside, it would be easier to have the understanding we should have. For example, if every time someone was exposed to gluten you could see an immune reaction, maybe then skin on the hands swelling with inflammation and cells actually dying so that we could all observe the damaged tissue and see how long it took to heal (more than the week between exposures if taking Communion at Sunday Mass) it might be more clear.

    As for gluten free seeming to be a choice of the upper classes, there are good and bad reasons for this. Yes, some folks simply prefer it because they have found a health improvement from it, some jump on the fad wagon. But it’s also true that Celiac is a hard disease to diagnose, tests ridiculously frequently have false negatives. Kids with Celiac are often treated as if the symptoms (stomach pain, digestive upset) are all in their heads (they just want out of class) or something they just need to suck it up and get over (adults seem to think kids need to put up with things like daily loose stool that we’d never tolerate for ourselves). The serious effects of Celiac, health consequences, show up from the malnutrition the damaged intestines causes, so many just feel crummy for decades and then finally get diagnosed after a serious health incident (terminal stomach cancer, for example) reveals the underlying cause.

    So, yes, those who are of a class where they have more money and time are much more likely to run to ground a Celiac diagnosis. The kid of the single mom on Medicaid gets to see one GP who says he needs to eat less junk food and sends him home. The kid with a mom who’s a lawyer and dad who’s a banker might get that, also, but they also might directly see a pediatric GI specialist and be easily able to pay copays for the more expensive tests that make diagnosis clearer.

    I would suggest that if a parish has a large number of wealthy that are gluten free, you might want to suggest those parishioners start some kind of parish outreach program to help the poorer parishioners who might have undiagnosed Celiac. Good way to bring class groups together as well as mitigate some of what may actually be a little spoilage among a few (nothing will make you feel sillier about making a big deal because gluten exposure makes your skin dry like hanging out with a kid who is underweight, has a distended stomach, and just spent all night throwing up from an exposure).

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  55. JenniferGM says:

    True Celiac disease has been around for centuries, and there are certain races that there is a high genetic rate. It seems like a recent phenomenon because it has been underdiagnosed for many decades in the US. Celiacs can’t be cured by drugs. The cure is to not eat gluten. Studies have not been in the forefront, and if the drug companies aren’t pushing the latest phase, doctors do tend to overlook. But as mentioned above, true Celiac diagnosis requires a biopsy and is a big process.

    But there are two other factors, one mentioned above is gluten intolerance. This has been a big rage, but it’s very real. The book “Wheat Belly” is the best example of explaining how genetically modified wheat that we have today is not the same as our grandparents’ wheat, and our bodies are reacting. But it’s not a life-threatening disease like celiac. I am wheat intolerant. When I do eat wheat, I develop arthritic type symptoms, so I avoid it. But I still receive Communion under the species of wheat hosts.

    My son is the other factor not mentioned. He has a true allergy to wheat. His body reacts and it can be life-threatening anaphylaxis. The gluten-reduced hosts are not an option for him, because the hosts are still wheat. So he receives from a special chalice that does not have conmingling.

    I have been truly grateful that in the Ordinary Form of the Mass that there is this option for him to receive safely. Am I correct that he has no option in the Extraordinary Form?

  56. Steph C says:

    Suellen said:
    “…I offered my, “Because, Jesus wouldn’t hurt me” answer. “NO! That is not why! You are receiving with no ill effects because IT’S NOT WHEAT!” Only the appearance of wheat remains. It’s human tissue. Human heart tissue. Sacred Heart Tissue. I understand this takes quite a bit of faith. I understand that the Church has to be sensitive to people and their conditions. And yet, what a profound teaching moment. It’s. Not. Wheat. Better still, He’s not wheat. Five years later, I still can’t eat gluten, by am a healthy daily communicant…”

    Fr.Z, would you please respond to this poster’s comments? [No need. The person who posted that doesn't understand that though the substance of the bread has changed, and is no longer, the accidents remain. The accidents of alcohol remaining in the Precious Blood can still intoxicate. The accidents of gluten can still provoke problems.] It’s late, I’m exhausted & falling asleep with the laptop on my pregnant belly in bed, but I can’t seem to locate the proper documents on transubstantiation, substance, accidents, (and cannibalism) through my usual sources (like Catholic Answers.) I respect Suellen’s sincere and deep faith, but I believe she is incorrect, as was her spiritual director.

    Suellen, might there be instead a medical explanation for the change in *you*?

  57. RuralVirologist says:

    Suellen’s comment may have been technically problematic in terms of substance, accidents, etc., but my initial reaction was that it was not an insightless statement, but an affirmation of a miracle.

    The miracle could be real, and she is spared the effects of the accidents because of what the substance is. It could also be a psychological thing – the sincere belief creates a psychological state where there is no pathological reaction to the accidents. This sort of thing – faith overcoming physical symptoms – has been seen before. And, if CS Lewis is right, this may not be an either/or situation – it could be God working in her through the power of faith over phsyical conditions.

    The miracle could be tested by giving her a consecrated host and an unconsecrated host, a) unblinded, and b) blinded, and then monitoring her response. I see no need to do this, for various reasons including the ethics of exposing her to the dangers of gluten.

  58. biberin says:

    StephC, thanks for bringing it back up. I do not dispute the poster’s experience, but I would hate for a newly diagnosed Catholic celiac to find this discussion via google, and think that if s/he just had enough faith, Jesus wouldn’t hurt her, or the accidents of gluten wouldn’t be an issue, and then avoid asking for a low gluten host.

  59. Steph C says:

    Fr.Z, Rural Virologist & Biberin, thanks for the quick replies.

    I, too, believe in miracles. I believe that Suellen’s experience with the Blessed Sacrament (& yet persisting gluten intolerance in other food) can happen.

    I also know, based on familiarity with food allergies & intolerances, of the variation in accurate & thorough testing.

    Being a Catholic and therefore blessed with the pillars of faith and reason as a foundation, I have faith that Our Lord could allow such an unusual miracle to take place, but my reason tells me also that the human body is pretty complicated & can easily “stump” or “fool” your average medical doctor.

    But, if I had just been told that my child had either a) celiac disease or b) a wheat allergy, I would hate to find this thread & expect my child to be able to consume a low-gluten host just because someone said “it’s not wheat.” The accidents of gluten, as Fr.Z clarified, remain.

  60. Suellen says:

    It is my understanding through my spiritual director that the “accident” only refers to the appearance. Is this incorrect? What of the Eucharistic Miracles which have been tested and the DNA shown to be the same as heart tissue and the same blood (AB-BA) as other Eucharistic miracles? Don’t you believe in those? I do. With all of my non-sacred heart. As to my condition changing, that was 4 1/2 years ago, and, as of yet, though I pray about it regularly, it has not changed. If Fr. Z is correct and the priest I spoke with is wrong, I can only conclude I am experiencing an on-going miracle which I am most grateful for. I had my biopsy AFTER I began receiving under both species again and I AM celiac. For all of the orthodoxy going on here, for which I am most grateful for, is there still no room for faith? By the way, my spiritual director gave me the sage advice to offer the inconveniences associated with the condition up for priests. I do so every day. If I ever am healed of celiac, my one regret will be no longer having that to offer for our beloved priests.

  61. biberin says:

    “Appearance” includes all the perceptions of our natural senses. So your everyday Eucharistic miracle changes bread and wine into the substance of Body and Blood, but they taste, smell, look and digest like the bread and wine they used to be, retaining those accidents. There is no apparent cardiac tissue, no blood with a blood type, no human DNA. In the Eucharistic miracles where the accidents also change, that’s a whole different deal, where the appearance does become Body and Blood.

    There is absolutely still room here for faith, which is why no one disputes what you say about being able to tolerate the regular hosts when an equivalent amount of gluten in a non-consecrated form would bother you. My concern, and I think other commenters agree, is that one must be careful never to imply that if celiacs just had enough faith, we could receive the regular hosts without a problem. The Church does not ask us to believe that the accidents are gone away; quite the opposite.

    I think that if I were in a parish which was not willing to use low gluten hosts or a separate chalice, my faith would probably lead me to receive anyway, trusting that the benefit would outweigh the risk, especially since my symptoms are not severe and I can fairly easily avoid other sources of cross-contamination. As it is, I have the best of both worlds–I can receive Jesus daily without having to risk my health, so I receive gratefully.

  62. Steph C says:

    Suellen,
    I hope you do not feel picked on for your comment! That was my fear, but never my intent, in raising the issue again for clarification. As I expressed above, I *do* have faith that Our Lord could allow such a miracle to occur, even *for you alone.*
    In terms of full-disclosure, I am also neck-deep in dealing with the medical reality of food allergies for my child, however, and in 8 years of keeping him alive, have learned a degree’s worth about the intricacies & varieties of allergy and intolerance testing and diagnosis.
    I was grateful to see the headline that lead me to Fr.Z’s original post, and somewhat cautiously scrolled through the comments, as it is common for biases and misunderstandings to abound about such matters.
    As I stated, I just would hate for the parent of a child with Celiac disease who is preparing for his or her First Holy Communion this spring to come across the post & comments and be misinformed, either medically or spiritually.
    God bless & Happy Gluten-Free Thanksgiving to you!