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Prepare the ingredients by dicing the onion, mincing the garlic, and chopping the peppers into uniform pieces.
Sauté aromatics by warming oil in a large skillet, then add onion and garlic, cooking until fragrant and translucent.
Incorporate base ingredients: stir in the tomatoes, coconut milk, sour cream, and tomato paste, simmering for 3 minutes.
Add fish and peppers to the skillet, seasoning with salt, pepper, and optional red pepper flakes, cooking for 2 minutes.
Simmer the stew on low heat for at least 10 minutes, ensuring the fish becomes flaky.
Garnish and serve the stew hot with cilantro and enjoy with crusty bread or rice.