I have seen some people complain online about items needing to be nerfed, but I have to think that they’re missing the point of the game.
For instance, picking up Ipecac and Tiny Planet grants you exploding shots that are as harmful to your enemies as they are to you, yourself. Of course, there’s always a downside, and with this mechanic you can easily set yourself up for some trouble. It’s led to this incredible metagame of trying to find out what the most overpowered combination of items you can put together is. This means picking up a combination of Brimstone and Mom’s Eye allows you to shoot a massively powerful ray in two directions at once.
One of the coolest additions to The Binding of Isaac: Rebirth is that items now stack on each other.