Spray 6-quart multicooker pot with cooking spray. Select sauté function and add sausage and pepper flakes to pot. Cook until browned and crumbled, about 5 minutes. Stir in pasta, undrained tomatoes, water and butter. Place lid on pot and close pressure release valve. Select high pressure cook function and set for 2 minutes.
When time is up, allow for natural pressure release for 2 minutes before opening the pressure release valve to quick release the remaining steam; carefully remove lid. Stir in cream and cheeses until creamy and smooth.
