Heat one tablespoon oil in a large skillet. Slice the cooked Italian sausage and add to the skillet, turning as necessary until warmed through and browned in places. Remove from skillet and keep warm. Add the remaining olive oil and tomatoes, cook until starting to soften, then add the garlic, red pepper flakes and the remaining peppers and onions along with any juices, cooking for a minute or two longer.

Add spinach and cook until slightly wilted, tossing, then the cooked orzo and the Italian sausage, tossing together. Add a little of the reserved pasta water to moisten, if needed. Taste and add salt and pepper to taste; it may need quite a bit of salt, but keep in mind if cheese and/or olives are used, both can be salty.

Garnish with chopped parsley or basil, cheese of choice and chopped olives.