Is There a Pathophysiology to COPD Exacerbation?

COPD exacerbation is basically increased dyspnea, increased cough, increased production of sputum. Is there an underlying pathophysiology that sort of drives these exacerbations? I would also suggest from our experience that GERD and aspiration are very important to think of gastroenterally. And if somebody is aspirating and having, you know, exacerbations of their COPD, one would empirically want to include MRSA in your treatment.