Is it possible to rebuild the symbol databases without having to restart VS? Since our project solution is generated, VA gets out of sync. It would be nice to force a rebuild without need to click the Rebuild button and restart Visual Studio twice.
Unfortunately no, the symbol database rebuild requires a restart. But if it is only your solution that is being generated then this should not be required. Rebuilding the VA symbol database is partly for when you have changed your stable include directories.
External Modification of Source If external applications modify your source when your IDE is active and a project is open, you must enable "Watch for externally modified files" in the options dialog of Visual Assist if you want Visual Assist to recognize the changes immediately. If not, Visual Assist will recognize the changes when you reload your project.
If this wouldn't help, I would try next just to close and then reopen the solution to see if it's enough without rebuilding your symbol databases. VA might pick up the changes.