Step 1

In a 5 quart pan, cook and crumble beef over medium-high heat until no longer pink.

Step 2

Add the onion, green pepper, and mushrooms. Cook until tender, about 3-5 minutes. Drain if desired.

Step 3

Add beef mixture back to the pot and add garlic, water, tomato sauce, tomatoes, Italian seasoning, paprika, sugar, crushed red pepper flakes, Worcestershire sauce, salt, and pepper.

Step 4

Bring to a boil, cover and reduce heat to medium-low. Allow to simmer for 15-20 minutes.

Step 5

Add the elbow macaroni and stir well. Return lid and continue to simmer for 15 minutes or until the noodles are done.

Step 6

Allow to sit covered for 5-10 minutes and mix well before serving.