Preheat oven to 350 degrees. Spray a 9x13 baking dish with non stick spray and set aside.
In a skillet, heat oil or bacon grease to medium high. Slice the Cajun sausage into bite sized pieces. Cook in the oil, stirring until browned on all sides. Stir in the thinly sliced peppers and onions. Reduce heat to medium low. Continue to cook and stir until the vegetables are crisp tender.
Cook pasta according to package directions for al dente. (You want the pasta to be slightly firm. It will finish cooking during baking.)
Drain the pasta, and reserve the pasta water. In a large bowl or pan, combine the pasta, cream of mushroom soup, Rotel tomatoes, hot sauce, spices, and HALF of the shredded cheese. Add pasta water and stir to combine well.
Fold in the sausage and vegetables. Transfer to the baking dish. Sprinkle with the remaining cheese.
Cover with foil and bake for 20 minutes. Remove foil and bake for 10 more minutes until the cheese is golden and bubbly.