In a large pot, cook sausage over medium heat. Drain fat and add onion, celery, red pepper and carrots. Cook for 3 minutes. Add garlic, Italian seasoning, salt, pepper. Cook another minute.
Stir in broth, tomatoes and water. Bring to a simmer.
Turn heat to medium-high and then add in pasta. Cover and stir occasionally. Cook 10 minutes, or until tender. Add in spinach, stir then season to taste.
Ladle into bowls and top with parmesan and fresh herbs if desired.
