Behind the Scenes with the Communion-Avoiding Catholics
In which we parse out the reasons so many practicing Catholics with celiac disease skip Holy Communion altogether.
In a disconcerting twist on the Divine Physician theme, I ended up with a celiac disease diagnosis thanks to tests run with Holy Communion. We will skip most of that saga. Summary: Trust me on this one.
This was not an awareness-raising moment for me. I wrote about communion, evangelization, and wheat allergy back in 2015; in 2020 here’s the line from The Book, p. 181, within the context of parish hospitality and disability accommodations:
. . . Catholics with celiac disease, gluten allergy, or chemical allergies (which can include incense) report facing outright disbelief from pastoral staff who ascribe their medical condition to hysteria or lack of faith.
I wrote this referring to the many real people, all of them active, faithful Catholics, who personally shared their stories with me. Space didn’t allow me to go into details, nor even be as precise and complete in my terms as I wish, but I thought, at the time, that just the reminder should be adequate to get an interested sacristan on the trail.
Fast forward to 2024.
In my fresh round of research on Holy Communion and celiac disease, I came across two main themes:
Not everyone can tolerate low-gluten hosts (for wheat-related allergies, a wheat-based host is an absolute no-go), though for some people it works great.
Quite a few people leave the Church over this.
If someone is absolutely determined to have a rice-based or other host that is invalid matter, there is not a ton you can do to change that. I do think listening, gentle catechesis, and working together on solutions would probably go a long ways with those who initially feel that the valid options are unsuitable.
—> In my sampling of online departure-stories, concern about a child feeling excluded or not fully part of the community is the predominant theme.
In any case, that was not me, and that is not the group of Catholics this post is mostly about.
Continuing my story: So I decided that I’d see about whether I could tolerate a low-gluten host before I approached my parish about going that route. I had a trip out of town already on the calendar, so I got to test the waters in a parish with a lovely sacristan who was super careful about following procedures to avoid cross-contamination, and it seemed to go fine.
Perfect. My pastor back home said to order the (valid) hosts of my choice, and there we were. I went with the lowest gluten levels among the suppliers who test and report that info. Done.
It seemed very straightforward.
With wheat allergies, the risk is anaphylaxis, which can be fatal. For a Catholic with a wheat allergy who wants to receive Holy Communion, the only safe option is to receive from a chalice that is not the presider’s chalice, and which no one who has received a host has drunk from.
—> This seems like a super simple solution to implement, and it’s also a solution that works for anyone with celiac disease who is fine with receiving the Precious Blood. It doesn’t require purchasing special items, just deploying a second chalice in strategic order.
Interestingly, in my sample of five parishes across four dioceses, when I spoke to the priest or sacristan about receiving communion, my proposal of receiving from an uncontaminated chalice was declined every time. For some reason, people really really want to give you a host. I don’t know why this is.
Also, two tips:
Ushers/greeters seem to universally know nothing. You have to find the sacristan.
I was informed at the National Shrine of the Immaculate Conception that they don’t offer low-gluten hosts, it’s strictly BYO. (But it was an HDO and I was offered a host consecrated at a student Mass the hour before, thank you CUA students for stocking the tabernacle.)
The three parishes in major cities that I sampled all had low-gluten hosts on hand, ready to go. In all three cases, though, the odds were in my favor: One was affiliated with a Catholic university; one was a mega-parish with a gung-ho, not-playing-around evangelization game; and one was a tiny parish, but in DC.
Things were going well.
Unlike allergies, where the dropping dead (or almost) happens fast, with celiac disease and the more serious forms of non-celiac gluten intolerance the reactions run on several levels:
an immediate reaction within two hours, most commonly nausea or vomiting;
associated symptoms over the next several days to weeks, which can vary greatly;
longer-term complications that are more likely with uncontrolled disease.
Even though in my case it was the extremely distinctive digestive symptoms that were the clincher in realizing what was going on, for me personally the joint pain and brain damage are the real problems. I’m not wild about the increased odds of cancer either.
As with allergies, celiac disease and non-celiac gluten intolerance can develop at any age, and reactions can change over time, growing more severe or becoming triggered by a smaller exposure.
I am not a ten-year-old boy so I will spare you the graphic details, but now that we know what we’re looking at, as it happens I get an extremely distinctive auto-immune reaction that is gluten-specific.
Which gets us closer to the point of this post, which is not about me, but did require me learning some more things.
We were humming along at my parish with the low-gluten hosts until cross-contamination became a thing. The first instance I wasn’t entirely sure had even happened, and I reserved judgement. The second was massive and honestly kinda disabling for several days afterward.
In both instances, we’re pretty sure that the cause was the deacon or extraordinary minister handling regular hosts prior to giving me communion. (So yes, the Lord is quite present on the minister’s hands by the end of distribution. I’m in awe whenever I think about it.)
So I got online to hunt around for good instructions on ideal procedures to prevent cross-contamination and I found two things:
Nearly all published parish and diocesan instructions for distributing low-gluten hosts that I came across were not adequate to prevent cross-contamination;
There are quite a lot of practicing Catholics with celiac disease who just never receive communion.
The one good set of instructions I found was this article I could only get to come up in my search results in a direct-to-PDF link: “Eucharistic Hospitality for Those with Celiac Disease” from Pastoral Liturgy, May/June 2024.
Give that a read and then let’s talk about the Eucharistic drop-outs.
Celiac disease is common enough that statistically speaking it’s highly unlikely a given parish has no one with the disease — even more unlikely if we lump into that group the wheat allergies and serious cases of non-celiac gluten intolerance. So I was astonished when the pastor of my fairly large parish said no one had ever approached him about this.
My prior digging around explained some of this. There’s a portion of Catholics who take the St. Rose of Lima approach, receiving a regular host and offering up the ensuing symptoms (which can be quite alarming).
There is also a significant portion of people with celiac disease who do not strictly follow a gluten-free diet in regular life. If you’re going to be sneaking donut holes after Mass, it’s reasonable to assume you’re not going to be hitting up your pastor for low-gluten or gluten-free communion during.
There’s an overlapping portion who find that receiving just the Precious Blood with whatever amount of cross-contamination has occurred is manageable. Either they experience no symptoms or tolerable symptoms (whatever that means in their case).
In all three of these categories, it’s a bit like smoking, drinking, or picking fights in bars: People have different risk/benefit calculations for how they want to manage their life.
So that whittles down our pool. Among those who do receive low- or no-gluten communion:
I’m inferring based on the published instructions for distribution I’ve seen from many parishes and dioceses, there must exist a fourth group who receive a low-gluten host and find whatever level of cross-contamination occurs at their parish to be acceptable.
It’s a bit like being a non-smoker who doesn’t mind the odd whiff of second-hand smoke, because it doesn’t seem to affect them in any negative way.
Likewise, there must be a group of people who do not receive the host, but do have access to a chalice that is either completely uncontaminated or close-enough for the recipient’s purposes.
Which leaves us the non-receivers.
What would make a practicing Catholic completely give up on receiving Our Lord?
It’s not alcohol intolerance or grape allergy. (Though that unfortunate no-win subset exists, and for laypeople the option of mustum appears essentially out of reach, please speak up if you know of a case where a parish has accommodated a regular pewsitter.)
It don’t think it’s lack of faith or desire.
I suspect it’s that fighting the fight is just too exhausting.
The thing about Holy Communion is that you don’t want to be randomly electro-shocked when you attempt to receive.
If you know that your request for a low-gluten host or a no-gluten chalice is going to be received cheerfully and without pushback, you’re confident in asking.
That’s not always the reality.
If you know that you aren’t going to end up feeling ill for days afterwards because your parish always, every time, follows the necessary procedures to prevent cross-contamination, you’re confident in receiving. That, too, is not always the reality.
Once you’ve been stung enough times, you give up. You get tired of trying to justify your right as a Catholic to receive communion in a form that doesn’t wreck you, or you just can’t afford to get wrecked. Or both.
I write this long thing because I think we as evangelists should know that there’s a portion of Catholics who are self-excommunicated out of sheer exhaustion and misery.
I’d encourage you to do what you can to find them hiding out in your shadow parish and see if it’s possible to help them receive the Lord again.
Photo: The Last Supper, woodcarving on display at the Catholic parish in Munster, France. (Where the cheese comes from, but we skipped that tour.)
If the accidents of the Host still remain after consecration, even though it is now truly the Body of Christ, then the gluten effects are real.
Along the same lines, as a recovering alcoholic, I have been criticized for never taking the Precious Blood; that I lack faith, because, after all, it is "no longer wine." But the accidents remain, right? I do believe the wine has truly become the Precious Blood of Christ, but the smell and taste of wine disturb me. And now, from these readings, it seems there's actually alcohol in the Precious Blood. Is that correct?
Thank you.
I'm in the weird third category. Not celiac, not wheat-allergic. But when my hands had eczema that persisted for over a year, my doctor suggested that sometimes cutting out gluten seemed to help. And it did. I still receive communion, I can feel it in my gut that my body is reacting to the host, but so far I can tolerate the reaction. I still fear the day is coming when like my sister I will decide I need to stop receiving altogether. She receives from a separate chalice when she can-- she can't always. She's also homebound though, and seldom gets to Mass. And eucharistic ministers can't bring the precious blood. Once she did have a priest friend who brought newly-consecrated wine to her at home. My youngest daughter had a wheat allergy that she fortunately outgrew right before her first communion. But I was thinking a lot about what we would do.... Parishes need to do better.