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the fuel pressure regulator is not functioning right and it's letting to much fuel in to the injectors or the fuel return line to the canister or from the canister back to the tank is kinked or blocked
not much info to go on. more info would be helpful. for example does it run fine for a few then it dies. my guess is a fuel filter or pump. you can run it till it dies and then hook up a fuel gauge to see if it has any pressure. when they get hot thy will lock up. so if your suppose to have 50 psi. and it gets hot. you might not get 10 psi and it wont run with less then 30 psi if its fuel injected
This is a good engine but they need work from time to time. What is the outside temperature while you experience this hard start? If you plug in the block heater, does the engine start better? Is the engine light on or does it come on at times while you are driving? Hard starts can be related to several different issues. This engine isn't easy to work on unless you have an advanced scan-tool. You need to look at live data and run some tests. The more common failures are clogged fuel and air filter. Dirty ,worn, or defective fuel injectors, low fuel-line fuel pressure, poor oil quality or low oil level, worn or defective ICP sensor, low injection pump pressure, loose or leaking IPR valve, or low compression. These examples should help get you started. You may need to have the truck diagnosed so you know what direction to go in. If you need any additional information, please write back. Good luck.
Three things to look at. You didnt say if it was carb or injected. If it has a carb then most likely the fuel in the carb bowl is leaking down and causes it to start hard. Or the choke is closing/sticking and causing same. Also look at the heat shield that goes between the starter and the exhaust. It may be gone and when the starter gets hot it wont work as well.
Take a can of parts cleaner and spay it around the throttle body to check for a leak and if it is not there then sprat it around were your vacum hoses are connected to the engine that is how i check for vacum leaks.