Brown the ground beef in a large skillet with the onions, bell peppers, garlic, salt and pepper.
Drain off any excess grease.
Add in the Worcestershire sauce, tomato sauce, Italian seasoning, water and macaroni. Mix well.
Bring to a broil, reduce heat to low, cover and simmer for 15 minutes until the macaroni is the tenderness that you desire. Mix all ingredients together thoroughly.