Add 2 tsp salt to a large pot of water and bring to a boil. Cook pasta according to package directions for al dente pasta.

In a separate large pan over medium-high heat, cook sausage throughly. If adding garlic or green chopped green peppers, they can be added with sausage at this time.

Prior to draining pasta, scoop out approximately 1/2 cup of pasta water and set aside.

Once sausage is completely cooked, use a slotted spoon to transfer to a plate.

Return the hot skillet to the stovetop, still on medium-high heat, and pour 1/2 cup of pasta water into pan to deglaze the hot pan. Use a spatula to really scrape any brown bits off the bottom of the pan so that they combine with the pasta water. Reduce heat to medium and add in heavy cream. If using additional ingredients, they can be added at this time. Reduce heat to medium and let sauce simmer for 3-5 minutes to thicken. Keep a close eye on it and stir often to avoid burning.

Once sauce has thickened, drained pasta can be added to the sauce. Stir well to combine and evenly coat the pasta. Add in sausage and stir well to combine.

Serve immediately.