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My guess is that you are experiencing a vapor lock problem. It was very common with this E350 series. It is caused by running too low of octane in your fuel. The engine produces more heat with lower octane fuels. This makes the exhaust manifold extremely hot. The fuel lines run right along the inside of the frame, right by the exhaust manifold, causing the fuel to get super heated. As long as you use a fuel with at least 87 octane, you should be alright. In many states, the regular gas has an octane rating of only 85. In those states, you will need to run the mid-grade gas or use an octane booster product.

or check for vaccum leakes.

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Q: Why would a 1986 Ford E350 lose power and backfire on uphill grades?
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