Item: Belly Button
While firing, Isaac gains a green aura that poisons nearby enemies.
While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
Grants 2 Heart Containers and completely restores health.
A familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knock back, poison, or charm all nearby enemies.
Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
The Black Bean
When taking damage, Isaac farts, causing poison damage to all enemies in range.
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Eye of Belial
Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Grants charged tears that deal greater damage when fully charged.
Tears have a chance to charm enemies.
Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Spear of Destiny
In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Follows Isaac around shooting normal tears.
Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.