Bring a large pot of salted water to a boil. Add pasta and cook until al dente, about 8-10 minutes. Reserve a cup of pasta water, then drain.

In a large skillet, heat olive oil over medium heat. Add the Italian sausage and cook until browned and crispy, about 5-7 minutes.

Add sliced bell peppers, chopped onions, and minced garlic to the skillet. Sauté for 4-5 minutes until tender.

Pour in crushed tomatoes and heavy cream. Stir in Italian seasoning and let simmer for 5-8 minutes until thickened.

Add drained pasta to the skillet and toss gently in the sauce. Mix in reserved pasta water if sauce is too thick.

Stir in grated Parmesan cheese, adjust seasoning, and serve hot. Garnish with additional cheese if desired.