In a large pot, bring salted water to a boil and add your choice of pasta. Cook according to package instructions until al dente, usually about 8-10 minutes. Before draining, reserve about a cup of the pasta water, then drain the pasta and set it aside.

In a large skillet, heat 1 tablespoon of olive oil over medium heat. Add Italian sausage to the pan, breaking it into crumbles. Sauté for 5-7 minutes until browned and cooked through. Transfer the sausage to a plate and set aside.

In the same skillet, add sliced bell peppers, onion, and minced garlic. Sauté for 4-5 minutes until the vegetables are tender and the onions are translucent.

Pour in crushed tomatoes and heavy cream, stirring in Italian seasoning. Bring to a simmer and let cook for about 5-7 minutes, allowing the sauce to thicken.

Add the cooked pasta back to the skillet with the sauce, tossing everything together. If the sauce is too thick, add reserved pasta water to achieve the desired consistency.

Remove from heat and stir in grated Parmesan cheese, adjusting seasoning with salt and pepper. Serve hot, garnished with extra cheese and fresh herbs.