
Lazarus' Rags causes ? to be resurrected as Lazarus Risen when he dies, allowing the gathering of heart containers.Hallowed Ground turns all The Poop uses into holy poops.Gimpy has a chance to spawn Soul Hearts when hit.Dim Bulb is able to be activated every room due to the single charge on The Poop, providing a consistent stat boost.Dead Cat will set Soul Hearts to 1, but can be used to gain devil deals by sacrificing the extra lives.
Dark Bum can now also drop pills, cards, and runes, which can include V - The Hierophant, Balls of Steel, or Rune of Dagaz. Dark Bum converts useless Red Hearts into Black Hearts and Spiders. Mitre and Daemon's Tail replace useless Red Hearts with Soul and Black Hearts respectively. Crown of Light will always activate when entering a room, but still deactivates after taking damage. Like Abaddon, this item is always safe to take. Ceremonial Robes costs three two Soul Hearts and grants three Black Hearts and damage up. Book of Revelations Spawns soul hearts. The XI - Strength card gives ? a permanent soul heart. The Rune of Dagaz grants one soul heart as well as lifting any curses. Balls of Steel pills or V - The Hierophant grant two soul hearts, both of which are more useful than normal HP up items. Athame can be used to produce black hearts upon taking damage. Abaddon will give 2 black hearts on pickup, essentially refunding the cost to obtain the item from a Devil Room. Abaddon can be bought safely regardless of current health, because its price can be deducted from the acquired Black Hearts retroactively. Abaddon costs three Soul Hearts and grants six Black Hearts, damage up, fear shot, and no negative effects to ?. Birthright: Soul Hearts gained from health ups will be doubled. ? has an innate Lil Larva effect destroying a poop while playing as him will spawn a Blue Fly. The amount of Soul Hearts it costs to purchase an item in Devil Room deals is equal to its Red Heart container cost, unlike other characters with no red health for whom it will always cost 3 soul hearts.
Bone Hearts grant an empty Bone Heart upon pickup, but they cannot be refilled using Red Hearts.Other utilities to the poop includes generating pickup, repelling projectiles once per room and destroying retracted spikes, benefitting ?'s defensive playstyles.Furthermore, in rooms with non-flying enemies that chase the player (except Spiders), the poop can be used in a corner of the room making ? untouchable, allowing the player to kill them without taking damage (if the player moves away from the pile of Poop generated, this will no longer work). The Poop - While not the most useful item, it can allow ? to cross small gaps by bombing the Poop from the opposite side, much like one would for Rocks.
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Enemies who deal full hearts of damage can be very dangerous in the early floors of the game.Sleeping on a bed will give ? three Soul Hearts.